1871548016 NPI number — WAYNE COUNTY HOSPITAL, INC

Table of content: (NPI 1871548016)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871548016 NPI number — WAYNE COUNTY HOSPITAL, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WAYNE 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:
1871548016
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
166 HOSPITAL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTICELLO
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42633-2430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-348-9343
Provider Business Mailing Address Fax Number:
606-340-3258

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
166 HOSPITAL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTICELLO
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42633-2416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-348-9343
Provider Business Practice Location Address Fax Number:
606-340-3258
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MURRELL
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
606-348-9343

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 38039 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 02809 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 35830 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: 35830 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: 38039 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: 02809 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282NC0060X , with the licence number: 600074 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X , with the licence number: 3003023 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 3006854 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 3002658 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 3010334 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: 2657A , 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: 000000054708 . This is a "ANTHEM BC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 74900994 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000076139 . This is a "ANTHEM BC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 01021781 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000054709 . This is a "ANTHEM- SKILLED NURSING" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000057551 . This is a "ANTHEM-RURAL HEALTH CLINI" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000108553 . This is a "ANTHEM BC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 3500047 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 65923542 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000382062 . This is a "ANTHEM-EMERGENCY MEDICIN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000061965 . This is a "ANTHEM BC" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 5000047 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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