Organization
HENRY COUNTY MEMORIAL HOSPITAL
Active
Other names
Fairway Village
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN VANCAMP (CEO OF ASC)
(317) 788-2500
Entity
Organization
Contact information
Practice address
2630 S KEYSTONE AVE, INDIANAPOLIS, IN 46203
(317) 787-8951
(317) 780-2550
Mailing address
2630 S KEYSTONE AVE, INDIANAPOLIS, IN 46203-5563
(317) 787-8951
(317) 780-2550
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
06-004700-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100266630C
—
IN
Enumeration date
01/16/2007
Last updated
10/27/2025
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