Provider Demographics
NPI:1699833129
Name:PUTNAM COUNTY HOSPITAL
Entity Type:Organization
Organization Name:PUTNAM COUNTY HOSPITAL
Other - Org Name:PUTNAM PEDIATRICS AND INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MESCALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-655-2576
Mailing Address - Street 1:1542 S BLOOMINGTON ST
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:GREENCASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:46135-2212
Mailing Address - Country:US
Mailing Address - Phone:765-658-2700
Mailing Address - Fax:765-658-2703
Practice Address - Street 1:1542 S BLOOMINGTON ST
Practice Address - Street 2:SUITE 1300
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135-2212
Practice Address - Country:US
Practice Address - Phone:765-658-2700
Practice Address - Fax:765-658-2703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health