1255335873 NPI number — NORTON HOSPITALS, 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 1255335873 NPI number — NORTON HOSPITALS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTON HOSPITALS, 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:
NORTON DIAGNOSTIC CENTER- FERN CREEK
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:
1255335873
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 776788
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60677-5070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-629-8000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9344 CEDAR CENTER WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40291-4522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-753-3390
Provider Business Practice Location Address Fax Number:
503-753-3399
Provider Enumeration Date:
06/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GAST
Authorized Official First Name:
SHELLEY
Authorized Official Middle Name:
Authorized Official Title or Position:
VP MANAGED CARE
Authorized Official Telephone Number:
502-272-5335

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X , with the licence number:  861108954 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000502016 . This is a "ANTHEM PROV NUM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01012764 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50012980 . This is a "PASSPORT PROV NUM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 65942476 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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