Provider Demographics
NPI:1174630594
Name:MAJOR HOSPITAL
Entity Type:Organization
Organization Name:MAJOR HOSPITAL
Other - Org Name:MILNER COMMUNITY HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HORNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:371-398-5252
Mailing Address - Street 1:370 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROSSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46065-9461
Mailing Address - Country:US
Mailing Address - Phone:765-379-2112
Mailing Address - Fax:765-379-2942
Practice Address - Street 1:370 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROSSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46065-9461
Practice Address - Country:US
Practice Address - Phone:765-379-2112
Practice Address - Fax:765-379-2942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN050002991313M00000X
IN13-000299-1313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000203401OtherANTHEM BLUE CROSS BLUE SH
IN000000203401OtherANTHEM BLUE CROSS BL
IN100286940Medicaid
IN000000203401OtherANTHEM BLUE CROSS BLUE SH