Healthcare Provider Details

I. General information

NPI: 1629698808
Provider Name (Legal Business Name): DECATUR COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2020
Last Update Date: 04/17/2020
Certification Date: 04/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6712 RESTORACY DRIVE
WHITESTOWN IN
46075-0089
US

IV. Provider business mailing address

720 NORTH LINCOLN STREET
GREENSBURG IN
47240-1398
US

V. Phone/Fax

Practice location:
  • Phone: 317-769-8888
  • Fax:
Mailing address:
  • Phone: 812-663-4331
  • Fax: 812-663-1316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. CATHERINE ELIZABETH KECK
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 812-669-4331