Provider Demographics
NPI:1811199037
Name:BOARD OF TRUSTEES OF HOWARD COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:BOARD OF TRUSTEES OF HOWARD COMMUNITY HOSPITAL
Other - Org Name:HOWARD REGIONAL HEALTH SYSTEM - SOUNDOS MOUALLA, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-453-8179
Mailing Address - Street 1:PO BOX 1751
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1751
Mailing Address - Country:US
Mailing Address - Phone:765-864-5725
Mailing Address - Fax:765-864-5726
Practice Address - Street 1:3611 S REED RD
Practice Address - Street 2:SUITE 106
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3828
Practice Address - Country:US
Practice Address - Phone:765-864-5725
Practice Address - Fax:765-864-5726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200011260HMedicaid
IN200011260HMedicaid