Provider Demographics
NPI:1467650655
Name:MARGARET MARY COMMUNITY HOSPITAL, INC.
Entity Type:Organization
Organization Name:MARGARET MARY COMMUNITY HOSPITAL, INC.
Other - Org Name:MARGARET MARY PHYSICIAN PARTNERS
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:DAEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-933-5135
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-0236
Mailing Address - Country:US
Mailing Address - Phone:812-933-5441
Mailing Address - Fax:812-933-5446
Practice Address - Street 1:11137 US HIGHWAY 52 STE B
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:IN
Practice Address - Zip Code:47012-7901
Practice Address - Country:US
Practice Address - Phone:765-647-3547
Practice Address - Fax:765-647-2170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035790261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200109760AMedicaid