Healthcare Provider Details

I. General information

NPI: 1578997482
Provider Name (Legal Business Name): METHODIST HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 12/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N ELM ST STE 1A
HENDERSON KY
42420-2385
US

IV. Provider business mailing address

PO BOX 638706
CINCINNATI OH
45263-8706
US

V. Phone/Fax

Practice location:
  • Phone: 270-631-2412
  • Fax: 270-827-7475
Mailing address:
  • Phone: 270-827-7558
  • Fax: 270-827-7530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BENNY J NOLEN
Title or Position: CEO
Credential:
Phone: 270-827-7501