1710035423 NPI number — KNOX HOSPITAL CORPORATION

Table of content: (NPI 1710035423)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710035423 NPI number — KNOX HOSPITAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KNOX HOSPITAL CORPORATION
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:
KNOX COUNTY 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:
1710035423
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
80 HOSPITAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARBOURVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40906-7363
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-546-4175
Provider Business Mailing Address Fax Number:
606-545-5511

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
80 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARBOURVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40906-7363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-546-4175
Provider Business Practice Location Address Fax Number:
606-545-5511
Provider Enumeration Date:
01/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MORGAN
Authorized Official First Name:
CRAIG
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
606-546-4175

Provider Taxonomy Codes

  • Taxonomy code: 3336I0012X , with the licence number:  P07514 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2030289 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5400983200 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com