1144205758 NPI number — BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION

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 1144205758 NPI number — BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BOWLING GREEN WARREN COUNTY COMMUNITY 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:
THE MEDICAL CENTER HOME CARE PROGRAM
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:
1144205758
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 90010
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOWLING GREEN
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42102-9010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-745-1467
Provider Business Mailing Address Fax Number:
270-745-1156

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1953 SCOTTSVILLE RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
BOWLING GREEN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42104-3388
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-745-1006
Provider Business Practice Location Address Fax Number:
270-745-1473
Provider Enumeration Date:
12/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LAWLESS
Authorized Official First Name:
MICHELE
Authorized Official Middle Name:
W
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT/CFO
Authorized Official Telephone Number:
270-745-1500

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  150033 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251G00000X , with the licence number: 150033 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 252Y00000X , with the licence number: 150033 , 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: 4204114500 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 34011148 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 45344850 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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