Provider Demographics
NPI:1952776338
Name:DECATUR COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:DECATUR COUNTY MEMORIAL HOSPITAL
Other - Org Name:TREE CITY MEDICAL PARTNERS
Other - Org Type:Doing Business As
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 1:955 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47240-1487
Mailing Address - Country:US
Mailing Address - Phone:812-663-5533
Mailing Address - Fax:812-663-9040
Practice Address - Street 1:955 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-1487
Practice Address - Country:US
Practice Address - Phone:812-663-5533
Practice Address - Fax:812-663-9040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health