Healthcare Provider Details

I. General information

NPI: 1790772382
Provider Name (Legal Business Name): MAJOR HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 12/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 LUTHER DR
CROWN POINT IN
46307-5043
US

IV. Provider business mailing address

1200 LUTHER DR
CROWN POINT IN
46307-5043
US

V. Phone/Fax

Practice location:
  • Phone: 219-663-3860
  • Fax: 219-661-8431
Mailing address:
  • Phone: 219-663-3860
  • Fax: 219-661-8431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0500005151
License Number StateIN

VIII. Authorized Official

Name: JOHN M HORNER
Title or Position: PRESIDENT & CEO
Credential:
Phone: 317-421-2012