1306854856 NPI number — MILLER'S HEALTH SYSTEMS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306854856 NPI number — MILLER'S HEALTH SYSTEMS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MILLER'S HEALTH SYSTEMS, 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:
MILLER'S SENIOR LIVING COMMUNITY
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:
1306854856
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4377
Provider Second Line Business Mailing Address:
1690 S COUNTY FARM ROAD
Provider Business Mailing Address City Name:
WARSAW
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46581-4377
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
574-267-7211
Provider Business Mailing Address Fax Number:
574-267-4908

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
303 N WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAKARUSA
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46573-9590
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
574-862-1918
Provider Business Practice Location Address Fax Number:
574-862-1916
Provider Enumeration Date:
08/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BOYLE
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
H
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
574-267-7211

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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