1447209119 NPI number — LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC., CAH

Table of content: (NPI 1447209119)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447209119 NPI number — LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC., CAH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC., CAH
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:
1447209119
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
131 HOSPITAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42078-8043
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-988-2299
Provider Business Mailing Address Fax Number:
270-988-3900

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARION
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42064-1543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-965-4377
Provider Business Practice Location Address Fax Number:
270-965-9569
Provider Enumeration Date:
05/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WHITTINGTON
Authorized Official First Name:
ROD
Authorized Official Middle Name:
SHANE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
270-988-7236

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X , with the licence number:  600071 , 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)

  • Identifier: 65944019 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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