Provider Demographics
NPI:1114016987
Name:HANCOCK REGIONAL HOSPITAL
Entity Type:Organization
Organization Name:HANCOCK REGIONAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE & BUSINESS SERV
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-485-4577
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-0129
Mailing Address - Country:US
Mailing Address - Phone:317-468-6221
Mailing Address - Fax:317-468-6267
Practice Address - Street 1:1 MEMORIAL SQ STE 100
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-2819
Practice Address - Country:US
Practice Address - Phone:317-462-3255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1114016987OtherNPI NUMBER FOR HANCOCK REGIONAL HOSPITAL -
IN000000493483OtherANTHEM PIN #
IN200941580AMedicaid
IN200841490Medicaid
IN1467485003OtherNPI NUMBER FOR HANCOCK REGIONAL HOSPITAL
IN247920Medicare Oscar/Certification
IN940020Medicare Oscar/Certification
I68320Medicare UPIN