# HENRY COUNTY MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hickory Creek at Madison
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104855980
- **Authorized official:** MR. BRIAN RING (PRESIDENT/CEO)
- **Authorized official phone:** (765) 521-1515

## Contact information

- **Practice address:** 1945 CRAGMONT ST, MADISON, IN 47250-2257
- **Practice address phone:** (812) 273-4696
- **Practice address fax:** (812) 273-6263
- **Mailing address:** 1945 CRAGMONT ST, MADISON, IN 47250-2257
- **Mailing address phone:** (812) 273-4696
- **Mailing address fax:** (812) 273-6263

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 05-000348-2 | IN | Yes |

## Other

- **Enumeration date:** 07/02/2006
- **Last updated:** 08/16/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100288390 | — | IN |