Provider Demographics
NPI:1316957814
Name:HANCOCK REGIONAL HOSPITAL
Entity type:Organization
Organization Name:HANCOCK REGIONAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUCKERHEIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-468-6236
Mailing Address - Street 1:156 W MUSKEGON DR
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-3069
Mailing Address - Country:US
Mailing Address - Phone:317-468-6221
Mailing Address - Fax:317-468-6267
Practice Address - Street 1:1 MEMORIAL SQ STE 100
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-2819
Practice Address - Country:US
Practice Address - Phone:317-462-3255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty