# PUTNAM COUNTY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Health Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114986924
- **Authorized official:** MR. DENNIS WEATHERFORD (PRESIDENT & CEO)
- **Authorized official phone:** (765) 655-2620

## Contact information

- **Practice address:** 1 SISTERS OF PROVIDENCE, PROVIDENCE HEALTH CARE CENTER, ST. MARY WOODS, IN 47876-1095
- **Practice address phone:** (812) 535-1051
- **Practice address fax:** (812) 535-1005
- **Mailing address:** P.O. BOX 97, ST. MARY OF THE WOODS, IN 47876-1095
- **Mailing address phone:** (812) 535-1051
- **Mailing address fax:** (812) 535-1005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/21/2006
- **Last updated:** 11/20/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 155802 | CCN | IN |
| 05 | — | 200429840A | — | IN |