Provider Demographics
NPI:1225043060
Name:MAJOR HOSPITAL
Entity Type:Organization
Organization Name:MAJOR HOSPITAL
Other - Org Name:MCCORMICK'S CREEK REHABILITATION AND HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-398-5252
Mailing Address - Street 1:210 STATE HIGHWAY 43
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IN
Mailing Address - Zip Code:47460-6725
Mailing Address - Country:US
Mailing Address - Phone:812-829-3444
Mailing Address - Fax:812-829-4999
Practice Address - Street 1:210 STATE HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IN
Practice Address - Zip Code:47460-6725
Practice Address - Country:US
Practice Address - Phone:812-829-3444
Practice Address - Fax:812-829-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200197620AMedicaid
IN000000098146OtherANTHEM BLUE CROSS PROVIDE
IN200197620AMedicaid