Healthcare Provider Details

I. General information

NPI: 1932672888
Provider Name (Legal Business Name): THE METHODIST HOSPITALS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 01/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GRANT ST
GARY IN
46402
US

IV. Provider business mailing address

600 GRANT ST
GARY IN
46402
US

V. Phone/Fax

Practice location:
  • Phone: 219-883-1710
  • Fax: 219-883-1711
Mailing address:
  • Phone: 219-883-1710
  • Fax: 219-883-1711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. RAYMOND GRADY
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 219-886-4432