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General NPI Number Information
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NPI Number | 1114179181
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Entity Type | Organization
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Legal Business Name | DECATUR COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 955 N MICHIGAN AVE STE 4
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City | GREENSBURG
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State | IN
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Zip | 47240-1487
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Country | US
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Telephone | 812-662-6450
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Fax |
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Provider Business Mailing Address
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Address Line | 720 N LINCOLN ST
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City | GREENSBURG
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State | IN
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Zip | 47240-1327
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Country | US
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Telephone | 812-663-1304
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Fax |
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Authorized Official
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Title or Position | AO/CEO/PRESIDENT
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Name | REX MCKINNEY
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Credential |
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Telephone | 812-663-1170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | 07-004714-1
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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