1104890714 NPI number — ROCKCASTLE COUNTY HOSPITAL INC

Table of content: (NPI 1104890714)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104890714 NPI number — ROCKCASTLE COUNTY HOSPITAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROCKCASTLE 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:
ROCKCASTLE REGIONAL HOSPITAL AND RESPIRATORY CARE CENTER
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:
1104890714
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
145 NEWCOMB AVE
Provider Second Line Business Mailing Address:
PO BOX 1310
Provider Business Mailing Address City Name:
MOUNT VERNON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40456-2733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-256-2195
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
145 NEWCOMB AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT VERNON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40456-2733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-256-2195
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BASTIN
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
NICHOLAS
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
606-256-2195

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 275N00000X , with the licence number: 100960 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 100960 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BP3500X , with the licence number: 100960 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: 100960 , 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: 000000061947 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000174204 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 90005547 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000054568 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 12700480 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000174199 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 45000106 . This is a "EPSDT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 01003425 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3500043 . This is a "UNITED HEALTH CARE LABS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 31F1 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 53J3 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 3900034 . This is a "UNITED HEALTH CARE LABS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 50-00043 . This is a "UNITED HEALTH CARE ACUTE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 65931818 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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