Provider Demographics
NPI:1326596123
Name:HENDRICKS COUNTY HOSPITAL
Entity Type:Organization
Organization Name:HENDRICKS COUNTY HOSPITAL
Other - Org Name:HENDRICKS REGIONAL HEALTH PLASTIC AND RECONSTRUCTIVE SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN NETWORK DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GENIEVEE
Authorized Official - Middle Name:S
Authorized Official - Last Name:KLAYER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MBA
Authorized Official - Phone:317-837-5571
Mailing Address - Street 1:100 HOSPITAL LN
Mailing Address - Street 2:SUITE 325
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-1989
Mailing Address - Country:US
Mailing Address - Phone:317-718-7980
Mailing Address - Fax:317-718-7989
Practice Address - Street 1:100 HOSPITAL LN
Practice Address - Street 2:SUITE 325
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1989
Practice Address - Country:US
Practice Address - Phone:317-718-7980
Practice Address - Fax:317-718-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN354590Medicare PIN