Provider Demographics
NPI:1174511620
Name:METHODIST HEALTH, INC.
Entity Type:Organization
Organization Name:METHODIST HEALTH, INC.
Other - Org Name:DEACONESS UNION COUNTY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDA
Authorized Official - Middle Name:
Authorized Official - Last Name:EISENMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-827-7700
Mailing Address - Street 1:PO BOX 638705
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-8705
Mailing Address - Country:US
Mailing Address - Phone:270-827-7558
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:270-389-5059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY600057282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY01022110Medicaid
KY000000054531OtherBC/BS HOSPITAL
IN100034990BMedicaid
IL=========002Medicaid
KY01022110Medicaid
ILT=========OtherBC/BS OF IL HOSPITAL
ILT=========OtherBC/BS OF IL HOSPITAL
IN100034990BMedicaid