Healthcare Provider Details

I. General information

NPI: 1477521300
Provider Name (Legal Business Name): DAVIESS COUNTY HOSPITAL SWING BED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2006
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
47501-2120
US

IV. Provider business mailing address

PO BOX 32
WASHINGTON IN
47501-2120
US

V. Phone/Fax

Practice location:
  • Phone: 812-254-2760
  • Fax: 812-254-8636
Mailing address:
  • Phone: 812-254-2760
  • Fax: 812-254-8636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number010012
License Number StateIN

VIII. Authorized Official

Name: MR. AMANDA RODEWALD
Title or Position: CFO INTERIM
Credential:
Phone: 812-254-2760