Basic Information
| Provider Information | |||||||||
| NPI: | 1578971792 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HENDRICKS COUNTY HOSPITAL | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | HENDRICKS REGIONAL HEALTH BROWNSBURG HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5492 N RONALD REAGAN PKWY | ||||||||
| Address2: | |||||||||
| City: | BROWNSBURG | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461125618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178375570 | ||||||||
| FaxNumber: | 3178375580 | ||||||||
| Practice Location | |||||||||
| Address1: | 5492 N RONALD REAGAN PKWY | ||||||||
| Address2: | |||||||||
| City: | BROWNSBURG | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461125618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178375570 | ||||||||
| FaxNumber: | 3178375580 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2014 | ||||||||
| LastUpdateDate: | 04/27/2018 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | KLAYER | ||||||||
| AuthorizedOfficialFirstName: | GENI | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN NETWORK DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3177453786 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.