# PUTNAM COUNTY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wellbrooke of Avon
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619318185
- **Authorized official:** DENNIS WEATHERFORD (PRESIDENT AND CEO)
- **Authorized official phone:** (765) 655-2620

## Contact information

- **Practice address:** 10307 E COUNTY ROAD 100 N, INDIANAPOLIS, IN 46234-1250
- **Practice address phone:** (317) 273-2144
- **Practice address fax:** (515) 875-4780
- **Mailing address:** PO BOX 221648, LOUISVILLE, KY 40252-1648
- **Mailing address phone:** (502) 412-5847

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 013085 | IN | Yes |

## Other

- **Enumeration date:** 07/12/2013
- **Last updated:** 02/02/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 201279600A | — | IN |