Provider Demographics
NPI:1396807335
Name:BOARD OF TRUSTESS OF HOWARD COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:BOARD OF TRUSTESS OF HOWARD COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHEIF 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:CFO
Authorized Official - Phone:765-453-8179
Mailing Address - Street 1:PO BOX 3002
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-3002
Mailing Address - Country:US
Mailing Address - Phone:765-453-8666
Mailing Address - Fax:765-453-8506
Practice Address - Street 1:3505 S REED RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3838
Practice Address - Country:US
Practice Address - Phone:765-453-8666
Practice Address - Fax:765-453-8506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056223207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN=========OtherTAX IDENTIFICATION NUMBER