Provider Demographics
NPI:1619290897
Name:JAY COUNTY HOSPITAL
Entity Type:Organization
Organization Name:JAY COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-726-1818
Mailing Address - Street 1:1758 W 100 S
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47371-8204
Mailing Address - Country:US
Mailing Address - Phone:260-726-7616
Mailing Address - Fax:260-726-8165
Practice Address - Street 1:1758 W 100 S
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:IN
Practice Address - Zip Code:47371-8204
Practice Address - Country:US
Practice Address - Phone:260-726-7616
Practice Address - Fax:260-726-8165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty