1780688333 NPI number — CALDWELL COUNTY HOSPITAL, INC

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 1780688333 NPI number — CALDWELL COUNTY HOSPITAL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CALDWELL COUNTY HOSPITAL, 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:
Provider Other Organization Name Type Code:
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:
1780688333
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/24/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 410
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRINCETON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42445-0410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-365-0300
Provider Business Mailing Address Fax Number:
270-365-0332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42445-2301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-365-0300
Provider Business Practice Location Address Fax Number:
270-365-0332
Provider Enumeration Date:
06/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LOVELL
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
270-365-0300

Provider Taxonomy Codes

  • Taxonomy code: 2083X0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282NC0060X , with the licence number: 600072 , 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: 000000054479 . This is a "BLUE CROSS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 01006931 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000054480 . This is a "BLUE CROSS SWINGBED" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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