Organization
HENRY COUNTY MEMORIAL HOSPITAL
Active
Other names
Bethany Village
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE VAN CAMP CPA (CFO OF ASC)
(317) 788-2500
Entity
Organization
Contact information
Practice address
3518 S SHELBY ST, INDIANAPOLIS, IN 46227-3226
(317) 783-4042
(317) 781-3044
Mailing address
3518 S SHELBY ST, INDIANAPOLIS, IN 46227-3226
(317) 783-4042
(317) 781-3044
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10-000142-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100266940B
—
IN
Enumeration date
10/25/2005
Last updated
07/25/2023
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