=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861752669
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BOARD OF TRUSTEES OF HOWARD COMMUNITY HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/25/2012
-----------------------------------------------------
Last Update Date | 05/25/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 117 W SYCAMORE ST
-----------------------------------------------------
City | KOKOMO
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46901-4634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-453-8052
-----------------------------------------------------
Fax | 765-864-8711
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 7101
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46207-7101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-453-8052
-----------------------------------------------------
Fax | 765-864-8711
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | ALAN BIGGS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 765-453-8476
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------