Basic Information
| Provider Information | |||||||||
| NPI: | 1871825216 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HENDRICKS COMMUNITY HOSPITAL | ||||||||
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| OtherOrganizationName: | AVON COMMUNITY SCHOOLS WELLNESS CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8244 E US HIGHWAY 36 | ||||||||
| Address2: | STE. 1100 | ||||||||
| City: | AVON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461239575 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172723688 | ||||||||
| FaxNumber: | 3172727515 | ||||||||
| Practice Location | |||||||||
| Address1: | 7203 E US HIGHWAY 36 | ||||||||
| Address2: | |||||||||
| City: | AVON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461237967 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3175446135 | ||||||||
| FaxNumber: | 3175446139 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2010 | ||||||||
| LastUpdateDate: | 02/10/2010 | ||||||||
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| AuthorizedOfficialLastName: | DAWES | ||||||||
| AuthorizedOfficialFirstName: | DENNIS | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3177453500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QC1800X | 09005005 | IN | Y | Ambulatory Health Care Facilities | Clinic/Center | Corporate Health |
No ID Information.