Healthcare Provider Details

I. General information

NPI: 1568729408
Provider Name (Legal Business Name): MUHLENBERG COMMUNITY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2012
Last Update Date: 10/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 LEGION DR SUITE 3
CENTRAL CITY KY
42330-1496
US

IV. Provider business mailing address

PO BOX 387
GREENVILLE KY
42345-0387
US

V. Phone/Fax

Practice location:
  • Phone: 270-757-0014
  • Fax: 270-757-0020
Mailing address:
  • Phone: 270-757-0014
  • Fax: 270-757-0020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number44957
License Number StateKY

VIII. Authorized Official

Name: MR. JOHN T. COUNTZLER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 270-338-8275