Healthcare Provider Details

I. General information

NPI: 1710039508
Provider Name (Legal Business Name): THE METHODIST HOSPITALS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GRANT ST ADMINISTRATION BUILDING
GARY IN
46402-6001
US

IV. Provider business mailing address

8701 BROADWAY ATTN CBO
MERRILLVILLE IN
46410-7035
US

V. Phone/Fax

Practice location:
  • Phone: 219-886-4404
  • Fax: 219-881-5199
Mailing address:
  • Phone: 219-738-5985
  • Fax: 219-736-4144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number06-005002-1
License Number StateIN

VIII. Authorized Official

Name: MR. MATHEW BOYLE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 219-886-4404