Provider Demographics
NPI:1104831718
Name:COLUMBUS REGIONAL HOSPITAL
Entity Type:Organization
Organization Name:COLUMBUS REGIONAL HOSPITAL
Other - Org Name:MAJESTIC CARE OF BEDFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VP AND CHIEF FINANCIAL OF
Authorized Official - Prefix:
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-376-5644
Mailing Address - Street 1:2400 17TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-5351
Mailing Address - Country:US
Mailing Address - Phone:812-379-4441
Mailing Address - Fax:
Practice Address - Street 1:2111 NORTON LN
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-4522
Practice Address - Country:US
Practice Address - Phone:812-279-4437
Practice Address - Fax:812-277-2796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100274460BMedicaid
IN000000098145OtherANTHEM BLUE CROSS
IN100450900AMedicaid
IN000000098145OtherANTHEM BLUE CROSS