1548215437 NPI number — TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORPORATION

Table of content: (NPI 1548215437)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548215437 NPI number — TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES 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:
TAYLOR COUNTY HOME SERVICES
Provider Other Organization Name Type Code:
4
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:
1548215437
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 270
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMPBELLSVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42719-0270
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-465-6341
Provider Business Mailing Address Fax Number:
270-789-5883

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 OLD LEBANON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMPBELLSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42718-9662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-465-6341
Provider Business Practice Location Address Fax Number:
270-789-5883
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WHEATLEY
Authorized Official First Name:
JANE
Authorized Official Middle Name:
G
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
270-465-3561

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  150109 , 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: 34010918 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00000054660 . This is a "BLUE CROSS PROVIDER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 42011098 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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