MEDICARE: DECATUR 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
1	282NC0060X	Critical Access Hospital	07-004714-1	IN

Other Identifiers

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

General Provider Information

NPI Number	:	1588637201
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DECATUR COUNTY MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	720 N LINCOLN ST
Second Line	:
City	:	GREENSBURG
State	:	IN
Zip	:	47240-1327
Country	:	US
Telephone Number	:	812-663-4331
Fax Number	:	812-663-9738

Provider Business Practice Location Address
First Line	:	955 N MICHIGAN AVE
Second Line	:
City	:	GREENSBURG
State	:	IN
Zip	:	47240-1487
Country	:	US
Telephone Number	:	812-662-6119
Fax Number	:	812-663-2176

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. WILLIAM R. ALLOY
Credential	:
Telephone Number	:	812-663-1170

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	09/09/2008

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Directions to “DECATUR COUNTY MEMORIAL HOSPITAL ” Practice Location

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