Organization
HENRY COUNTY MEMORIAL HOSPITAL
Active
Other names
The Waters of Muncie
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN RING (PRESIDENT/CEO)
(765) 521-1515
Entity
Organization
Contact information
Practice address
2400 CHATEAU DR, MUNCIE, IN 47303-1900
(765) 747-9044
(765) 747-4954
Mailing address
2400 CHATEAU DR, MUNCIE, IN 47303-1900
(765) 747-9044
(765) 747-4954
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
13-000310-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381419
ANTHEM BCBS
IN
01
—
000000391194
ANTHEM PT
IN
01
—
000000391195
ANTHEM ST
IN
05
—
100288970C
—
IN
01
—
5586760001
DMERC REGION B SUPPLIER#
IN
Enumeration date
06/01/2006
Last updated
08/16/2022
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