1841374667 NPI number — KENTUCKY EASTER SEAL SOCIETY INC

Table of content: (NPI 1841374667)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841374667 NPI number — KENTUCKY EASTER SEAL SOCIETY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KENTUCKY EASTER SEAL SOCIETY 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:
CARDINAL HILL SPECIALTY HOSPITAL
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:
1841374667
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4728
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40544-4728
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-254-5701
Provider Business Mailing Address Fax Number:
859-233-1615

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
85 N GRAND AVENUE
Provider Second Line Business Practice Location Address:
ST LUKE HOSPITAL EAST
Provider Business Practice Location Address City Name:
FORT THOMAS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-572-3880
Provider Business Practice Location Address Fax Number:
859-572-3895
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GILLIHAN
Authorized Official First Name:
KERRY
Authorized Official Middle Name:
GIL
Authorized Official Title or Position:
PRESIDENT CEO
Authorized Official Telephone Number:
859-254-5701

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01000306 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000327149 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2506069 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50008447 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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