1992794788 NPI number — NEW GLASGOW HEALTH & REHABILITATION CENTER, LLC

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 1992794788 NPI number — NEW GLASGOW HEALTH & REHABILITATION CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW GLASGOW HEALTH & REHABILITATION CENTER, LLC
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:
6
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:
1992794788
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 938
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLASGOW
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42142-0938
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-651-6661
Provider Business Mailing Address Fax Number:
270-651-7881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 WESTWOOD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLASGOW
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42141-1028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-651-6661
Provider Business Practice Location Address Fax Number:
270-651-7881
Provider Enumeration Date:
10/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
GUMM
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
JASON
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
270-651-6661

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  100014 , 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)





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