Provider Demographics
NPI:1629337589
Name:DAVIESS COUNTY HOSPITAL
Entity Type:Organization
Organization Name:DAVIESS COUNTY HOSPITAL
Other - Org Name:DCH DIABETES & ENDOCRINOLOGY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSSFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-254-2760
Mailing Address - Street 1:1402 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-2122
Mailing Address - Country:US
Mailing Address - Phone:812-254-7310
Mailing Address - Fax:812-257-8602
Practice Address - Street 1:1402 GRAND AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-2122
Practice Address - Country:US
Practice Address - Phone:812-254-7310
Practice Address - Fax:812-257-8602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01053199A261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center