1588894703 NPI number — MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION

Table of content: (NPI 1588894703)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588894703 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:
MURRAY PSYCHIATRIC ASSOCIATES
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:
1588894703
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 S 8TH ST
Provider Second Line Business Mailing Address:
STE 480W
Provider Business Mailing Address City Name:
MURRAY
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42071-2400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-753-0704
Provider Business Mailing Address Fax Number:
270-762-3626

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
719 ELM 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-761-0043
Provider Business Practice Location Address Fax Number:
270-761-0045
Provider Enumeration Date:
07/22/2009

Additional Information

Authorized Official

Authorized Official Last Name:
BRADFORD
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
270-762-1104

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0804X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 7100551590 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100119010 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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