Provider Demographics
NPI:1740655299
Name:DECATUR COUNTY MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:DECATUR COUNTY MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF AMBULATORY SRVC.
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-222-0793
Mailing Address - Street 1:718 N LINCOLN ST
Mailing Address - Street 2:STE A
Mailing Address - City:GREENSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47240-1348
Mailing Address - Country:US
Mailing Address - Phone:812-662-0588
Mailing Address - Fax:812-663-5932
Practice Address - Street 1:718 N LINCOLN ST
Practice Address - Street 2:STE A
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-1348
Practice Address - Country:US
Practice Address - Phone:812-662-0588
Practice Address - Fax:812-663-5932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health