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General NPI Number Information
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NPI Number | 1952452815
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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 | 01/16/2007
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 2630 S KEYSTONE AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46203
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Country | US
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Telephone | 317-787-8951
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Fax | 317-780-2550
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Provider Business Mailing Address
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Address Line | 2630 S KEYSTONE AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46203-5563
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Country | US
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Telephone | 317-787-8951
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Fax | 317-780-2550
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Authorized Official
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Title or Position | CEO OF ASC
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Name | STEVEN VANCAMP
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Credential |
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Telephone | 317-788-2500
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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 | 06-004700-1
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License Number State | IN
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