Provider Demographics
NPI:1871825216
Name:HENDRICKS COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:HENDRICKS COMMUNITY HOSPITAL
Other - Org Name:AVON COMMUNITY SCHOOLS WELLNESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:DAWES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-745-3500
Mailing Address - Street 1:8244 E US HIGHWAY 36
Mailing Address - Street 2:STE. 1100
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-9575
Mailing Address - Country:US
Mailing Address - Phone:317-272-3688
Mailing Address - Fax:317-272-7515
Practice Address - Street 1:7203 E US HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7967
Practice Address - Country:US
Practice Address - Phone:317-544-6135
Practice Address - Fax:317-544-6139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN09005005261QC1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health