# PUTNAM COUNTY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Waters of Greencastle
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518905447
- **Authorized official:** MR. DENNIS WEATHERFORD (PRESIDENT/CEO)
- **Authorized official phone:** (765) 655-2620

## Contact information

- **Practice address:** 1601 HOSPITAL DR, GREENCASTLE, IN 46135-2268
- **Practice address phone:** (765) 653-2602
- **Practice address fax:** (765) 653-2387
- **Mailing address:** 1601 HOSPITAL DR, GREENCASTLE, IN 46135-2268
- **Mailing address phone:** (765) 653-2602
- **Mailing address fax:** (765) 653-2387

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 05-000109-1 | IN | Yes |

## Other

- **Enumeration date:** 06/03/2006
- **Last updated:** 10/08/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000381424 | ANTHEM BCBS | IN |
| 01 | — | 000000476414 | ANTHEM PT | IN |
| 01 | — | 000000476415 | ANTHEM OT | IN |
| 01 | — | 000000476416 | ANTHEM ST | IN |
| 05 | — | 100266290C | — | IN |
| 01 | — | 5586590001 | DMERC REGION B SUPPLIER\# | IN |