Healthcare Provider Details

I. General information

NPI: 1710362157
Provider Name (Legal Business Name): ADAMS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 07/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 S ANDREWS RD
YORKTOWN IN
47396-6812
US

IV. Provider business mailing address

1100 MERCER AVE PO BOX 151
DECATUR IN
46733-2303
US

V. Phone/Fax

Practice location:
  • Phone: 765-759-7740
  • Fax:
Mailing address:
  • Phone: 260-724-2145
  • Fax:

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: DANE WHEELER
Title or Position: CFO/TREASURER
Credential:
Phone: 260-724-2145