1427389717 NPI number — BOARD OF TRUSTEES OF HOWARD COMMUNITY HOSPITAL

Table of content: (NPI 1427389717)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427389717 NPI number — BOARD OF TRUSTEES OF HOWARD COMMUNITY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BOARD OF TRUSTEES OF HOWARD COMMUNITY 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:
Provider Other Organization Name Type Code:
6
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:
1427389717
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2312 S DIXON RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
KOKOMO
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46902-6401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
765-865-6633
Provider Business Mailing Address Fax Number:
765-865-6634

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2312 S DIXON RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
KOKOMO
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46902-6401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-865-6633
Provider Business Practice Location Address Fax Number:
765-865-6634
Provider Enumeration Date:
01/26/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
THEODORE
Authorized Official Middle Name:
T
Authorized Official Title or Position:
CFO/VP OF FINANCE
Authorized Official Telephone Number:
765-453-8476

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  02003531 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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