Basic Information
| Provider Information | |||||||||
| NPI: | 1467650655 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MARGARET MARY COMMUNITY HOSPITAL, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MARGARET MARY PHYSICIAN PARTNERS | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 236 | ||||||||
| Address2: | |||||||||
| City: | BATESVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 470060236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8129335441 | ||||||||
| FaxNumber: | 8129335446 | ||||||||
| Practice Location | |||||||||
| Address1: | 11137 US HIGHWAY 52 STE B | ||||||||
| Address2: | |||||||||
| City: | BROOKVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 470127901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656473547 | ||||||||
| FaxNumber: | 7656472170 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2007 | ||||||||
| LastUpdateDate: | 01/03/2020 | ||||||||
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| AuthorizedOfficialLastName: | DAEGER | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8129335135 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | 01035790 | IN | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.