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General NPI Number Information
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NPI Number | 1629013487
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Entity Type | Organization
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Legal Business Name | HENRY COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 5480 25TH ST
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City | COLUMBUS
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State | IN
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Zip | 47203-3330
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Country | US
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Telephone | 812-372-6136
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Fax | 812-372-8726
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Provider Business Mailing Address
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Address Line | 6081 E 82ND ST SUITE 120
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-1795
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Country | US
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Telephone | 317-570-0266
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Fax | 317-570-0488
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. BRIAN RING
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Credential |
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Telephone | 765-521-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 05-000284-2
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License Number State | IN
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