Provider Demographics
NPI:1932449154
Name:PUTNAM COUNTY HOSPITAL
Entity Type:Organization
Organization Name:PUTNAM COUNTY HOSPITAL
Other - Org Name:CENTURY VILLA HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:S
Authorized Official - Last Name:BORUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-655-2620
Mailing Address - Street 1:705 N MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:GREENTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46936-1246
Mailing Address - Country:US
Mailing Address - Phone:765-628-3377
Mailing Address - Fax:765-628-3950
Practice Address - Street 1:705 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:GREENTOWN
Practice Address - State:IN
Practice Address - Zip Code:46936-1246
Practice Address - Country:US
Practice Address - Phone:765-628-3377
Practice Address - Fax:765-628-3950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility