Provider Demographics
NPI:1235487448
Name:MAJOR HOSPITAL
Entity type:Organization
Organization Name:MAJOR HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HORNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-392-3211
Mailing Address - Street 1:1316 N TIBBS AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-3024
Mailing Address - Country:US
Mailing Address - Phone:317-634-8330
Mailing Address - Fax:317-263-9442
Practice Address - Street 1:1316 N TIBBS AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-3024
Practice Address - Country:US
Practice Address - Phone:317-634-8330
Practice Address - Fax:317-263-9442
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAJOR HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-20
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
155389Medicare Oscar/Certification