Healthcare Provider Details

I. General information

NPI: 1760396642
Provider Name (Legal Business Name): PORTER HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2206 ROOSEVELT RD STE B
VALPARAISO IN
46383-9618
US

IV. Provider business mailing address

85 E US HIGHWAY 6
VALPARAISO IN
46383-8947
US

V. Phone/Fax

Practice location:
  • Phone: 219-548-9990
  • Fax: 219-263-4600
Mailing address:
  • Phone: 219-263-4600
  • Fax: 219-263-4882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: PAULA LALOR
Title or Position: SR DIRECTOR
Credential:
Phone: 629-215-3953