Provider Demographics
NPI:1710039508
Name:THE METHODIST HOSPITALS, INC.
Entity Type:Organization
Organization Name:THE METHODIST HOSPITALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCFADDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-886-4404
Mailing Address - Street 1:600 GRANT ST
Mailing Address - Street 2:ADMINISTRATION BUILDING
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46402-6001
Mailing Address - Country:US
Mailing Address - Phone:219-886-4404
Mailing Address - Fax:219-881-5199
Practice Address - Street 1:600 GRANT ST
Practice Address - Street 2:ADMINISTRATION BUILDING
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46402-6001
Practice Address - Country:US
Practice Address - Phone:219-886-4404
Practice Address - Fax:219-881-5199
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE METHODIST HOSPITALS,INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-18
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06-005002-1273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100268630CMedicaid
IN100268630BMedicaid
IN100268630AMedicaid
IN100268630CMedicaid