Provider Demographics
NPI:1083872840
Name:HENRY COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:HENRY COUNTY MEMORIAL HOSPITAL
Other - Org Name:DRAPER HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-521-1515
Mailing Address - Street 1:7023 S SPICELAND RD
Mailing Address - Street 2:
Mailing Address - City:SPICELAND
Mailing Address - State:IN
Mailing Address - Zip Code:47385-9765
Mailing Address - Country:US
Mailing Address - Phone:765-987-7059
Mailing Address - Fax:765-521-1212
Practice Address - Street 1:7023 S SPICELAND RD
Practice Address - Street 2:
Practice Address - City:SPICELAND
Practice Address - State:IN
Practice Address - Zip Code:47385-9765
Practice Address - Country:US
Practice Address - Phone:765-987-7059
Practice Address - Fax:765-521-1212
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENRY COUNTY MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-29
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty