Provider Demographics
NPI:1073620001
Name:HARRISON COUNTY HOSPITAL
Entity Type:Organization
Organization Name:HARRISON COUNTY HOSPITAL
Other - Org Name:HARRISON COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DUVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-734-3861
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IN
Mailing Address - Zip Code:47112-0038
Mailing Address - Country:US
Mailing Address - Phone:812-738-4251
Mailing Address - Fax:812-738-7833
Practice Address - Street 1:1141 HOSPITAL DR NW
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112-2164
Practice Address - Country:US
Practice Address - Phone:812-738-4251
Practice Address - Fax:812-738-7833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005073-1341600000X
IN06-004773-1341600000X
IN0325341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1065774Medicaid
KY01340306Medicaid
IN100128260AMedicaid
IN000000054339OtherANTHEM IN
IN36649630'0OtherBLACK LUNG
IN36649630'0OtherBLACK LUNG
IN=========000OtherCARESOURCE�
KY01340306�Medicaid
IN=========000OtherCARESOURCE�
IN=========F�OtherHUMANA AMBULANCE�