1851695019 NPI number — TRIUMPH HOSPITAL NORTHWEST INDIANA. LLC

Table of content: (NPI 1851695019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851695019 NPI number — TRIUMPH HOSPITAL NORTHWEST INDIANA. LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRIUMPH HOSPITAL NORTHWEST INDIANA. LLC
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:
Provider Other Organization Name Type Code:
6
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:
1851695019
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/06/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5454 HOHMAN AVE
Provider Second Line Business Mailing Address:
5TH FLOOR
Provider Business Mailing Address City Name:
HAMMOND
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46320-1931
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-937-9900
Provider Business Mailing Address Fax Number:
219-933-2298

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5454 HOHMAN AVE
Provider Second Line Business Practice Location Address:
5TH FLOOR
Provider Business Practice Location Address City Name:
HAMMOND
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-937-9900
Provider Business Practice Location Address Fax Number:
219-933-2298
Provider Enumeration Date:
01/03/2011

Additional Information

Authorized Official

Authorized Official Last Name:
DILLON
Authorized Official First Name:
TERRANCE
Authorized Official Middle Name:
K.
Authorized Official Title or Position:
ASSISTANT SECRETARY
Authorized Official Telephone Number:
502-596-7220

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X , with the licence number:  100088991 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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