Healthcare Provider Details

I. General information

NPI: 1336557511
Provider Name (Legal Business Name): MAJOR HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 12/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4180 SAGE BLUFF CROSSING
FORT WAYNE IN
46804
US

IV. Provider business mailing address

26691 RICHMOND RD
BEDFORD HEIGHTS OH
44146-1421
US

V. Phone/Fax

Practice location:
  • Phone: 260-443-7300
  • Fax:
Mailing address:
  • Phone: 216-292-5706
  • Fax: 216-292-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

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