Organization
ADAMS COUNTY MEMORIAL HOSPITAL
Active
Other names
Pilgrim Manor
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE SPRUNGER (ASSISTANT TREASURER)
(260) 724-2145
Entity
Organization
Contact information
Practice address
222 PARKVIEW STREET, PLYMOUTH, IN 46563-1152
(574) 936-9943
(574) 936-4310
Mailing address
1100 MERCER AVENUE, PO BOX 151, DECATAR, IN 46733-2303
(260) 724-2145
(574) 722-3894
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
05-000030-1
IN
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
05-000030-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097805
ANTHEM BCBS
—
01
—
100275260
ALTERNATE MEDICAID #
IN
01
—
100275260
AARP
—
05
—
100275260A
—
IN
Enumeration date
07/28/2005
Last updated
08/26/2025
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