HARRISON COUNTY HOSPITAL

Provider Demographics

• NPI: 1851378137
• Name: HARRISON COUNTY HOSPITAL
• Entity Type: Organization
• Organization Name: HARRISON COUNTY HOSPITAL
• Other - Org Name: HARRISON COUNTY HOSPITAL LAB
• Other - Org Type: Other Name
• Authorized Official - Title/Position: CFO
• Authorized Official - First Name: DONALD
• Authorized Official - Last Name: DUVAL
• Authorized Official - Phone: 812-738-4251
• Mailing Address - Street 1: 1141 HOSPITAL DR NW
• Mailing Address - City: CORYDON
• Mailing Address - State: IN
• Mailing Address - Zip Code: 47112-1774
• Mailing Address - Country: US
• Mailing Address - Phone: 812-738-7865
• Mailing Address - Fax: 812-738-7833
• Practice Address - Street 1: 1141 HOSPITAL DRIVE NW
• Practice Address - City: CORYDON
• Practice Address - State: IN
• Practice Address - Zip Code: 47112-2164
• Practice Address - Country: US
• Practice Address - Phone: 812-738-7865
• Practice Address - Fax: 812-738-7833
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2005-12-28
• Last Update Date: 2023-11-30

Provider Licenses

State	License ID	Taxonomies
IN	06-004773-1	207R00000X, 261QC0050X, 282N00000X, 282NC0060X, 291U00000X, 341600000X
IN	05005073-1	261QC0050X, 282N00000X, 282NC0060X, 291U00000X, 341600000X
		275N00000X, 341600000X, 3416L0300X
IN	0325	341600000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	282NC0060X	Hospitals	General Acute Care Hospital	Critical Access
No	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine		Group - Multi-Specialty
No	261QC0050X	Ambulatory Health Care Facilities	Clinic/Center	Critical Access Hospital	Group - Multi-Specialty
No	275N00000X	Hospital Units	Medicare Defined Swing Bed Unit		Group - Multi-Specialty
No	282N00000X	Hospitals	General Acute Care Hospital
No	291U00000X	Laboratories	Clinical Medical Laboratory		Group - Multi-Specialty
No	341600000X	Transportation Services	Ambulance
No	3416L0300X	Transportation Services	Ambulance	Land Transport

Provider Identifiers

State	Identifier ID	ID Type	Issuer
IN	000000054339	Other	ANTHEM IN
KY	01340306	Medicaid
KY	1065774	Medicaid
IN	300023026	Medicaid
KY	000000182520	Other	ANTHEM KY. LAB
IN	100268260A	Medicaid
IN	100128260A	Medicaid
IN	100268250A	Medicaid
IN	36649630'0	Other	BLACK LUNG
IN	151331B000000	Other	TRAILBLAZER
IN	200172560A	Medicaid
IN	15Z331	Medicare Oscar/Certification
IN	940190	Medicare PIN