Healthcare Provider Details

I. General information

NPI: 1164885372
Provider Name (Legal Business Name): MAJOR HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 01/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5805 N. FIR RD.
GRANGER IN
46530-4750
US

IV. Provider business mailing address

150 W WASHINGTON ST
SHELBYVILLE IN
46176-1236
US

V. Phone/Fax

Practice location:
  • Phone: 317-392-3211
  • Fax:
Mailing address:
  • Phone: 317-392-3211
  • Fax:

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 HORNER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 317-398-5252