Healthcare Provider Details

I. General information

NPI: 1841285913
Provider Name (Legal Business Name): PUTNAM COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S OAK ST
WINCHESTER IN
47394-2229
US

IV. Provider business mailing address

701 S OAK ST
WINCHESTER IN
47394-2229
US

V. Phone/Fax

Practice location:
  • Phone: 765-584-2201
  • Fax: 859-281-5150
Mailing address:
  • Phone: 765-584-2201
  • Fax: 765-584-1324

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: DENNIS WEATHERFORD
Title or Position: CEO
Credential:
Phone: 765-301-7531