=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184615270
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HARRISON COUNTY HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2005
-----------------------------------------------------
Last Update Date | 11/30/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1263 HOSPITAL DR NW STE 180
-----------------------------------------------------
City | CORYDON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47112-2170
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-738-1200
-----------------------------------------------------
Fax | 812-738-1710
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 38
-----------------------------------------------------
City | CORYDON
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47112-0038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 812-738-4251
-----------------------------------------------------
Fax | 812-738-7833
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | DONALD DUVAL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 812-738-4251
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LN0000X
-----------------------------------------------------
Taxonomy Name | Neonatal Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------