Provider Demographics
NPI:1700244779
Name:HENDRICKS COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:HENDRICKS COMMUNITY HOSPITAL
Other - Org Name:HENDRICKS REGIONAL HEALTH IMMEDIATE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIJANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMALLWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-272-3688
Mailing Address - Street 1:8244 E US HIGHWAY 36
Mailing Address - Street 2:SUITE 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:
Practice Address - Street 1:321 N. NORTHFIELD DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112
Practice Address - Country:US
Practice Address - Phone:317-272-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care