Provider Demographics
NPI:1720130537
Name:THE METHODIST HOSPITALS,INC. - PROGRESSIVE CARE UNIT
Entity type:Organization
Organization Name:THE METHODIST HOSPITALS,INC. - PROGRESSIVE CARE UNIT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-886-4171
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:46402-6099
Mailing Address - Country:US
Mailing Address - Phone:219-886-4000
Mailing Address - Fax:219-886-4603
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:46402-6099
Practice Address - Country:US
Practice Address - Phone:219-886-4000
Practice Address - Fax:219-886-4603
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:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05-005002-1314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN15-5652Medicare Oscar/Certification