Provider Demographics
NPI:1013197383
Name:METHODIST HEALTH, INC.
Entity Type:Organization
Organization Name:METHODIST HEALTH, INC.
Other - Org Name:METHODIST HOSPITAL UNION COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENNY
Authorized Official - Middle Name:J
Authorized Official - Last Name:NOLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-827-7501
Mailing Address - Street 1:4604 US HIGHWAY 60 W
Mailing Address - Street 2:
Mailing Address - City:MORGANFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42437-6515
Mailing Address - Country:US
Mailing Address - Phone:270-389-5000
Mailing Address - Fax:270-827-7530
Practice Address - Street 1:4604 US HIGHWAY 60 W
Practice Address - Street 2:
Practice Address - City:MORGANFIELD
Practice Address - State:KY
Practice Address - Zip Code:42437-6515
Practice Address - Country:US
Practice Address - Phone:270-389-5000
Practice Address - Fax:270-827-7530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY600057291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY01022110Medicaid
KY000000064415OtherBCBS
KY000000064415OtherBCBS