Provider Demographics
NPI:1912939315
Name:HANCOCK REGIONAL HOSPITAL
Entity Type:Organization
Organization Name:HANCOCK REGIONAL HOSPITAL
Other - Org Name:HOOVERWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEP
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:KEEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, FACHE
Authorized Official - Phone:317-452-5544
Mailing Address - Street 1:7001 HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-4169
Mailing Address - Country:US
Mailing Address - Phone:317-251-2261
Mailing Address - Fax:317-257-8423
Practice Address - Street 1:7001 HOOVER RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-4169
Practice Address - Country:US
Practice Address - Phone:317-251-2261
Practice Address - Fax:317-257-8423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100275310AMedicaid
IN100103110Medicaid
IN100275310AMedicaid