Healthcare Provider Details

I. General information

NPI: 1366409377
Provider Name (Legal Business Name): MAJOR HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 04/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 E NATIONAL HWY
WASHINGTON IN
47501-4128
US

IV. Provider business mailing address

PO BOX 737
WASHINGTON IN
47501-0737
US

V. Phone/Fax

Practice location:
  • Phone: 812-254-7159
  • Fax: 812-254-0242
Mailing address:
  • Phone: 812-254-7159
  • Fax: 812-254-0242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number050003031
License Number StateIN

VIII. Authorized Official

Name: MRS. JOHN M HORNER
Title or Position: C.E.O.
Credential: PRESIDENT
Phone: 317-398-5252