1427035476 NPI number — METHODIST HEALTH, INC.

Table of content: (NPI 1427035476)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427035476 NPI number — METHODIST HEALTH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METHODIST HEALTH, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DEACONESS UNION COUNTY DIXON
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427035476
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 638706
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45263-8706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-827-7558
Provider Business Mailing Address Fax Number:
270-827-7530

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1355 STATE HWY 41A S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DIXON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-639-9101
Provider Business Practice Location Address Fax Number:
270-639-9332
Provider Enumeration Date:
12/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
JENKINS
Authorized Official First Name:
STEPHANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
270-827-7118

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7100400500 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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