1821334483 NPI number — HENRY COUNTY MEMORIAL HOSPITAL

Table of content: MISS CHERIE ANNE MCDONALD MS ED, CAS, NCSP (NPI 1558594002)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821334483 NPI number — HENRY COUNTY MEMORIAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HENRY COUNTY MEMORIAL HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MULBERRY HEALTH & REHABILITATION CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821334483
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
502 W JACKSON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MULBERRY
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46058-9538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
765-296-2911
Provider Business Mailing Address Fax Number:
765-296-9516

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
502 W JACKSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MULBERRY
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46058-9538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-296-2911
Provider Business Practice Location Address Fax Number:
765-296-9516
Provider Enumeration Date:
12/28/2012

Additional Information

Authorized Official

Authorized Official Last Name:
RING
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
765-521-1515

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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