1073504981 NPI number — MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION

Table of content: (NPI 1073504981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073504981 NPI number — MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION
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:
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:
1073504981
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/10/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
803 POPLAR ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MURRAY
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42071-2432
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-762-1100
Provider Business Mailing Address Fax Number:
270-767-3657

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
803 POPLAR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURRAY
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42071-2432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-762-1100
Provider Business Practice Location Address Fax Number:
270-767-3657
Provider Enumeration Date:
10/31/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DAVISON
Authorized Official First Name:
KITTY
Authorized Official Middle Name:
REGINA
Authorized Official Title or Position:
ARRA COORDINATOR
Authorized Official Telephone Number:
270-762-1273

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  100053 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336I0012X , with the licence number: P05053 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 000000054618 . This is a "KY ACCESS PROV #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 27 . This is a "ACCORDIA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 279005 . This is a "HEALTHLINK PROVIDER #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000072460 . This is a "BC PRO-FEE PROVIDER #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 031200999 . This is a "U.S. DPT OF ENERGY PROV #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1069382 . This is a "PASSPORT HEALTH PROV. #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 9029 . This is a "CARE CHOICE PROV #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 5402535800 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000054618 . This is a "BC HOSPITAL #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000054618 . This is a "UNICARE PROVIDER #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 01008549 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000061955 . This is a "BC LAB FEE PROVIDER #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 163103600 . This is a "U.S. DEPT OF LABOR PROV #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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