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NPI Code Detail

MEDICARE: HENRY COUNTY MEMORIAL HOSPITAL

MEDICARE: HENRY COUNTY MEMORIAL HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility05-000348-2IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104855980
Entity Type Code : Organization
Provider Name (Legal Business Name) : HENRY COUNTY MEMORIAL HOSPITAL
Provider Business Mailing Address
First Line : 1945 CRAGMONT ST
Second Line :
City : MADISON
State : IN
Zip : 47250-2257
Country : US
Telephone Number : 812-273-4696
Fax Number : 812-273-6263
Provider Business Practice Location Address
First Line : 1945 CRAGMONT ST
Second Line :
City : MADISON
State : IN
Zip : 47250-2257
Country : US
Telephone Number : 812-273-4696
Fax Number : 812-273-6263
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MR. BRIAN RING
Credential :
Telephone Number : 765-521-1515
Provider Enumeration Date : 07/02/2006
Last Update Date : 08/16/2022

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Directions to “HENRY COUNTY MEMORIAL HOSPITAL ” Practice Location

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