Provider Demographics
NPI:1811313398
Name:JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FORGEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-522-4238
Mailing Address - Street 1:1529 LANCASTER ST
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-1507
Mailing Address - Country:US
Mailing Address - Phone:260-824-4320
Mailing Address - Fax:260-824-4689
Practice Address - Street 1:1529 LANCASTER ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-1507
Practice Address - Country:US
Practice Address - Phone:260-824-4320
Practice Address - Fax:260-824-4689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-08
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100273870CMedicaid
IN100273870CMedicaid