Healthcare Provider Details
I. General information
NPI: 1861708653
Provider Name (Legal Business Name): METHODIST HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2010
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1305 N ELM ST
HENDERSON KY
42420-2783
US
IV. Provider business mailing address
PO BOX 638706
CINCINNATI OH
45263-8706
US
V. Phone/Fax
- Phone: 270-827-1234
- Fax: 270-827-1235
- Phone: 270-827-7558
- Fax: 270-827-7530
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BENNY
J
NOLEN
Title or Position: CEO
Credential:
Phone: 270-827-7500