Provider Demographics
NPI:1427389717
Name:BOARD OF TRUSTEES OF HOWARD COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:BOARD OF TRUSTEES OF HOWARD COMMUNITY HOSPITAL
Other - Org Name:HOWARD REGIONAL ORTHOPAEDIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:T
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-453-8476
Mailing Address - Street 1:2312 S DIXON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-6401
Mailing Address - Country:US
Mailing Address - Phone:765-865-6633
Mailing Address - Fax:765-865-6634
Practice Address - Street 1:2312 S DIXON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-6401
Practice Address - Country:US
Practice Address - Phone:765-865-6633
Practice Address - Fax:765-865-6634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02003531207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty