Healthcare Provider Details

I. General information

NPI: 1144368853
Provider Name (Legal Business Name): THE METHODIST HOSPITAL MEDICAL NUTRITION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GRANT ST
GARY IN
46402-6001
US

IV. Provider business mailing address

600 GRANT ST
GARY IN
46402-6001
US

V. Phone/Fax

Practice location:
  • Phone: 219-886-4650
  • Fax: 219-886-4580
Mailing address:
  • Phone: 219-886-4650
  • Fax: 219-886-4580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number189450
License Number StateIN

VIII. Authorized Official

Name: RUTH D. ARGENTA
Title or Position: MANAGER MEDICAL NUTRITION SERVICES
Credential: R.D.
Phone: 219-886-4650