Organization
PUTNAM COUNTY HOSPITAL
Active
Other names
Providence Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS WEATHERFORD (PRESIDENT & CEO)
(765) 655-2620
Entity
Organization
Contact information
Practice address
1 SISTERS OF PROVIDENCE, PROVIDENCE HEALTH CARE CENTER, ST. MARY WOODS, IN 47876-1095
(812) 535-1051
(812) 535-1005
Mailing address
P.O. BOX 97, ST. MARY OF THE WOODS, IN 47876-1095
(812) 535-1051
(812) 535-1005
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
155802
CCN
IN
05
—
200429840A
—
IN
Enumeration date
03/21/2006
Last updated
11/20/2014
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