Healthcare Provider Details

I. General information

NPI: 1902913551
Provider Name (Legal Business Name): MAJOR HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 11/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8380 VIRGINIA ST
MERRILLVILLE IN
46410-6231
US

IV. Provider business mailing address

8380 VIRGINIA ST
MERRILLVILLE IN
46410-6231
US

V. Phone/Fax

Practice location:
  • Phone: 219-769-9009
  • Fax: 219-755-4522
Mailing address:
  • Phone: 219-769-9009
  • Fax: 219-755-4522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JOHN HORNER
Title or Position: PRESIDENT
Credential:
Phone: 317-398-5252