Organization
PUTNAM COUNTY HOSPITAL
Active
Other names
The Waters of Greencastle
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS WEATHERFORD (PRESIDENT/CEO)
(765) 655-2620
Entity
Organization
Contact information
Practice address
1601 HOSPITAL DR, GREENCASTLE, IN 46135-2268
(765) 653-2602
(765) 653-2387
Mailing address
1601 HOSPITAL DR, GREENCASTLE, IN 46135-2268
(765) 653-2602
(765) 653-2387
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05-000109-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000381424
ANTHEM BCBS
IN
01
—
000000476414
ANTHEM PT
IN
01
—
000000476415
ANTHEM OT
IN
01
—
000000476416
ANTHEM ST
IN
05
—
100266290C
—
IN
01
—
5586590001
DMERC REGION B SUPPLIER#
IN
Enumeration date
06/03/2006
Last updated
10/08/2014
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