1285655811 NPI number — BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION

Table of content: (NPI 1285655811)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285655811 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 AT SCOTTSVILLE
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:
1285655811
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 3560
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:
42102-3560
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-622-2826
Provider Business Mailing Address Fax Number:
270-622-2209

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
456 BURNLEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTTSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42164-6355
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-622-2821
Provider Business Practice Location Address Fax Number:
270-622-2208
Provider Enumeration Date:
07/21/2006

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: 275N00000X , with the licence number:  600076 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 282NC0060X , with the licence number: 600076 , 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: 12700647 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com