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1073504981

NPI Code Detail

MEDICARE: MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION

MEDICARE: MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336I0012X	Institutional Pharmacy	P05053	KY
2	3336L0003X	Long Term Care Pharmacy
3	282N00000X	General Acute Care Hospital	100053	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000054618	OTHER	KY	KY ACCESS PROV #
2	27	OTHER	KY	ACCORDIA
3	279005	OTHER	KY	HEALTHLINK PROVIDER #
4	000000072460	OTHER	KY	BC PRO-FEE PROVIDER #
5	031200999	OTHER	KY	U.S. DPT OF ENERGY PROV #
6	1069382	OTHER	KY	PASSPORT HEALTH PROV. #
7	9029	OTHER	KY	CARE CHOICE PROV #
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	000000054618	OTHER	KY	BC HOSPITAL #
10	000000054618	OTHER	KY	UNICARE PROVIDER #
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	000000061955	OTHER	KY	BC LAB FEE PROVIDER #
13	163103600	OTHER	KY	U.S. DEPT OF LABOR PROV #

General Provider Information

NPI Number	:	1073504981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION

Provider Business Mailing Address
First Line	:	803 POPLAR ST
Second Line	:
City	:	MURRAY
State	:	KY
Zip	:	42071-2432
Country	:	US
Telephone Number	:	270-762-1100
Fax Number	:	270-767-3657

Provider Business Practice Location Address
First Line	:	803 POPLAR ST
Second Line	:
City	:	MURRAY
State	:	KY
Zip	:	42071-2432
Country	:	US
Telephone Number	:	270-762-1100
Fax Number	:	270-767-3657

Authorized Official
Title or Position	:	ARRA COORDINATOR
Name	:	MRS. KITTY REGINA DAVISON
Credential	:
Telephone Number	:	270-762-1273

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	09/10/2021

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Directions to “MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION ” Practice Location

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