Healthcare Provider Details

I. General information

NPI: 1417160789
Provider Name (Legal Business Name): DAVIESS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 01/02/2021
Certification Date: 01/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 E WALNUT ST
WASHINGTON IN
47501-2860
US

IV. Provider business mailing address

1314 E WALNUT ST
WASHINGTON IN
47501-2860
US

V. Phone/Fax

Practice location:
  • Phone: 812-254-8634
  • Fax: 812-257-8609
Mailing address:
  • Phone: 812-254-8634
  • Fax: 812-257-8609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number01053053A
License Number StateIN

VIII. Authorized Official

Name: ANTHONY SHOWALTER
Title or Position: BOARD MEMBER
Credential:
Phone: 812-254-2760