Provider Demographics
NPI:1386276947
Name:HENDRICKS COUNTY HOSPITAL
Entity type:Organization
Organization Name:HENDRICKS COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-837-5566
Mailing Address - Street 1:301 SATORI PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-6408
Mailing Address - Country:US
Mailing Address - Phone:317-456-9028
Mailing Address - Fax:317-386-5520
Practice Address - Street 1:301 SATORI PKWY STE 150
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6408
Practice Address - Country:US
Practice Address - Phone:317-456-9028
Practice Address - Fax:317-386-5520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric