MEDICARE: MERCY HEALTH-LOURDES HOSPITAL LLC

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	314000000X	Skilled Nursing Facility	100754	KY

General Provider Information

NPI Number	:	1750387858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY HEALTH-LOURDES HOSPITAL LLC

Provider Business Mailing Address
First Line	:	1530 LONE OAK RD
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42003-7901
Country	:	US
Telephone Number	:	270-444-2163
Fax Number	:	270-444-2460

Provider Business Practice Location Address
First Line	:	1530 LONE OAK RD
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42003-7901
Country	:	US
Telephone Number	:	270-444-2163
Fax Number	:	270-444-2460

Authorized Official
Title or Position	:	CFO
Name	:	JOHN F DEMPSEY
Credential	:	BS MBA FHFMA
Telephone Number	:	270-444-2553

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	01/26/2022

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