Provider Demographics
NPI:1427133693
Name:HARRISON COUNTY HOSPITAL
Entity type:Organization
Organization Name:HARRISON COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:WILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-738-4251
Mailing Address - Street 1:1400 LAMMERS PIKE
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-8931
Mailing Address - Country:US
Mailing Address - Phone:812-934-5090
Mailing Address - Fax:
Practice Address - Street 1:1400 LAMMERS PIKE
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-8931
Practice Address - Country:US
Practice Address - Phone:812-934-5090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06-0046711314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200538760Medicaid
IN155742Medicare ID - Type Unspecified
155742Medicare Oscar/Certification