MEDICARE: MAJOR HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	313M00000X	Nursing Facility/Intermediate Care Facility
2	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1235487448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAJOR HOSPITAL

Provider Business Mailing Address
First Line	:	1316 N TIBBS AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-3024
Country	:	US
Telephone Number	:	317-634-8330
Fax Number	:	317-263-9442

Provider Business Practice Location Address
First Line	:	1316 N TIBBS AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-3024
Country	:	US
Telephone Number	:	317-634-8330
Fax Number	:	317-263-9442

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	MR. JOHN M HORNER
Credential	:
Telephone Number	:	317-392-3211

Provider Enumeration Date	:	08/20/2012
Last Update Date	:	10/01/2014

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Directions to “MAJOR HOSPITAL ” Practice Location

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