Provider Demographics
NPI:1770642167
Name:MAJOR HOSPITAL
Entity Type:Organization
Organization Name:MAJOR HOSPITAL
Other - Org Name:MUNSTER MED-INN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & 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 1:7935 CALUMET AVE
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-1215
Mailing Address - Country:US
Mailing Address - Phone:219-836-8300
Mailing Address - Fax:219-836-1814
Practice Address - Street 1:7935 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1215
Practice Address - Country:US
Practice Address - Phone:219-836-8300
Practice Address - Fax:219-836-1814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN060000562314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100289450Medicaid
IN0517630001Medicare NSC
IN155131Medicare Oscar/Certification