Provider Demographics
NPI:1417085770
Name:INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC
Entity Type:Organization
Organization Name:INDIANA UNIVERSITY HEALTH TIPTON HOSPITAL INC
Other - Org Name:IU HEALTH TIPTON HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARLOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-675-8501
Mailing Address - Street 1:1000 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TIPTON
Mailing Address - State:IN
Mailing Address - Zip Code:46072-9753
Mailing Address - Country:US
Mailing Address - Phone:765-675-8500
Mailing Address - Fax:765-675-8520
Practice Address - Street 1:1000 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TIPTON
Practice Address - State:IN
Practice Address - Zip Code:46072-9753
Practice Address - Country:US
Practice Address - Phone:765-675-8500
Practice Address - Fax:765-675-8250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000597049OtherANTHEM PIN
IN100270160AMedicaid
IN000000597049OtherANTHEM PIN