Healthcare Provider Details

I. General information

NPI: 1316939689
Provider Name (Legal Business Name): CLINTON COUNTY HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 06/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 BURKESVILLE RD
ALBANY KY
42602-1654
US

IV. Provider business mailing address

723 BURKESVILLE RD
ALBANY KY
42602-1654
US

V. Phone/Fax

Practice location:
  • Phone: 606-387-6421
  • Fax: 606-387-8550
Mailing address:
  • Phone: 606-387-6421
  • Fax: 606-387-8550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number100078
License Number StateKY

VIII. Authorized Official

Name: MR. J. D. MULLINS
Title or Position: ADMINISTRATOR
Credential:
Phone: 606-387-3600