Provider Demographics
NPI:1407048242
Name:THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Entity Type:Organization
Organization Name:THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Other - Org Name:TRINITY VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:BURKHART
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:317-788-2500
Mailing Address - Street 1:6900 GRAY RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-3209
Mailing Address - Country:US
Mailing Address - Phone:317-788-2500
Mailing Address - Fax:317-788-2509
Practice Address - Street 1:4301 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0678
Practice Address - Country:US
Practice Address - Phone:812-477-8971
Practice Address - Fax:812-477-7874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07 004805 2314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200808110AMedicaid
155749Medicare Oscar/Certification