MEDICARE: METHODIST HEALTH, INC.

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	363LF0000X	Family Nurse Practitioner
2	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346494671
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METHODIST HEALTH, INC.

Provider Business Mailing Address
First Line	:	PO BOX 638706
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-8706
Country	:	US
Telephone Number	:	270-827-7558
Fax Number	:	270-827-7530

Provider Business Practice Location Address
First Line	:	411 LETCHER ST
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-4245
Country	:	US
Telephone Number	:	270-831-7950
Fax Number	:	270-831-7824

Authorized Official
Title or Position	:	CEO
Name	:	MR. BENNY J NOLEN
Credential	:
Telephone Number	:	270-827-7501

Provider Enumeration Date	:	11/13/2008
Last Update Date	:	08/19/2019

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Directions to “METHODIST HEALTH, INC. ” Practice Location

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