Healthcare Provider Details

I. General information

NPI: 1629429360
Provider Name (Legal Business Name): T J SAMSON COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2016
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 E HAPPY VALLEY ST
CAVE CITY KY
42127-8844
US

IV. Provider business mailing address

PO BOX 645996
CINCINNATI OH
45264-5996
US

V. Phone/Fax

Practice location:
  • Phone: 270-773-2111
  • Fax: 270-773-2117
Mailing address:
  • Phone: 270-651-4444
  • Fax: 270-651-4892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NEIL THORNBURY
Title or Position: CEO
Credential:
Phone: 270-651-4159