1093711178 NPI number — NORTON HOSPITALS, INC

Table of content: (NPI 1093711178)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093711178 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 SOUTHWEST MEDICAL CENTER
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:
1093711178
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 35070
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40232-5070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9700 STONESTREET RD
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:
40272-2884
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-933-8100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GOUGH
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
W
Authorized Official Title or Position:
SENIOR VP CFO
Authorized Official Telephone Number:
502-629-8326

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  100475 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QA1903X , with the licence number: 100475 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 000000061919 . This is a "ANTHEM REF LAB PROV NUM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1049531 . This is a "PASSPORT PROV NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000297478 . This is a "ANTHEM IMPLANTS PROV NUM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000054676 . This is a "ANTHEM ACUTE PROV NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01012764 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0474137 . This is a "AETNA HMO PROV NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5000015 . This is a "UNITED HEALTHCARE PROV" identifier . This identifiers is of the category "OTHER".




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