# HENRY COUNTY MEMORIAL HOSPITAL

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

## Provider details

- **NPI number:** 1629013487
- **Authorized official:** MR. BRIAN RING (PRESIDENT/CEO)
- **Authorized official phone:** (765) 521-1515

## Contact information

- **Practice address:** 5480 25TH ST, COLUMBUS, IN 47203-3330
- **Practice address phone:** (812) 372-6136
- **Practice address fax:** (812) 372-8726
- **Mailing address:** 6081 E 82ND ST, SUITE 120, INDIANAPOLIS, IN 46250-1795
- **Mailing address phone:** (317) 570-0266
- **Mailing address fax:** (317) 570-0488

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 05-000284-2 | IN | Yes |

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 08/17/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100290690 | — | IN |