Healthcare Provider Details
I. General information
NPI: 1194156364
Provider Name (Legal Business Name): METHODIST HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/12/2013
Last Update Date: 12/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1305 N ELM ST STE C
HENDERSON KY
42420-2783
US
IV. Provider business mailing address
PO BOX 638706
CINCINNATI OH
45263-8706
US
V. Phone/Fax
- Phone: 270-827-5657
- Fax: 270-827-8833
- Phone: 270-827-7558
- Fax: 270-827-7530
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BENNY
J
NOLEN
Title or Position: CEO
Credential:
Phone: 270-827-7501