Provider Demographics
NPI:1639238116
Name:THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Entity Type:Organization
Organization Name:THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Other - Org Name:IRVINGTON NURSING AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:BURKHART
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:317-788-2500
Mailing Address - Street 1:344 S RITTER AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-7142
Mailing Address - Country:US
Mailing Address - Phone:317-359-5515
Mailing Address - Fax:317-322-3311
Practice Address - Street 1:344 S RITTER AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-7142
Practice Address - Country:US
Practice Address - Phone:317-359-5515
Practice Address - Fax:317-322-3311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11-004438-1314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100267500BMedicaid
IN155737Medicare Oscar/Certification