# HENDRICKS COUNTY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HENDRICKS COUNTY HOSPITAL
- **Other names:** GREEN ST FAMILY MEDICINE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104600048
- **Legal business name:** HENDRICKS COUNTY HOSPITAL
- **Authorized official:** HEATHER RUTHERFORD (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (317) 837-5566

## Contact information

- **Practice address:** 1080 N GREEN ST STE 200, BROWNSBURG, IN 46112-2417
- **Practice address phone:** (317) 386-5628
- **Practice address fax:** (317) 386-5629
- **Mailing address:** 1100 SOUTHFIELD DR STE 1370, PLAINFIELD, IN 46168-4300
- **Mailing address phone:** (317) 837-5566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/22/2023
- **Last updated:** 08/22/2023