Provider Demographics
NPI:1841285913
Name:PUTNAM COUNTY HOSPITAL
Entity type:Organization
Organization Name:PUTNAM COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WEATHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-301-7531
Mailing Address - Street 1:701 S OAK ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:47394-2229
Mailing Address - Country:US
Mailing Address - Phone:765-584-2201
Mailing Address - Fax:765-584-1324
Practice Address - Street 1:701 S OAK ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:IN
Practice Address - Zip Code:47394-2229
Practice Address - Country:US
Practice Address - Phone:765-584-2201
Practice Address - Fax:859-281-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100275450AMedicaid
IN100275450AMedicaid
IN155231Medicare Oscar/Certification