MEDICARE: ADAMS 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	314000000X	Skilled Nursing Facility	110002901	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	:	1922206952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAMS COUNTY MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	1100 MERCER AVENUE
Second Line	:
City	:	DECATUR
State	:	IN
Zip	:	46733-2303
Country	:	US
Telephone Number	:	260-724-2145
Fax Number	:	317-818-1430

Provider Business Practice Location Address
First Line	:	715 N MILL STREET
Second Line	:
City	:	HARTFORD CITY
State	:	IN
Zip	:	47348-1834
Country	:	US
Telephone Number	:	765-348-2273
Fax Number	:	765-348-2279

Authorized Official
Title or Position	:	ASSISTANT CFO
Name	:	MR. KYLE SPRUNGER
Credential	:	CPA
Telephone Number	:	260-724-2145

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	11/07/2022

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Directions to “ADAMS COUNTY MEMORIAL HOSPITAL ” Practice Location

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