Organization
DAVIESS COUNTY HOSPITAL
Active
Other names
Grand Avenue Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY SHOWALTER (PRESIDENT OF THE BOARD OF DIRECTORS)
(812) 254-8620
Entity
Organization
Contact information
Practice address
1402 GRAND AVE, WASHINGTON, IN 47501-2122
(812) 257-0383
(812) 257-0433
Mailing address
1402 GRAND AVE, WASHINGTON, IN 47501-2122
(812) 257-0383
(812) 257-0433
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270240C
—
IN
Enumeration date
03/23/2007
Last updated
01/02/2021
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