Healthcare Provider Details

I. General information

NPI: 1285878215
Provider Name (Legal Business Name): CALDWELL COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 FAIRVIEW AVENUE
EDDYVILLE KY
42038-8237
US

IV. Provider business mailing address

101 HOSPITAL DR PO BOX 410
PRINCETON KY
42445-2301
US

V. Phone/Fax

Practice location:
  • Phone: 270-388-5454
  • Fax: 270-388-5452
Mailing address:
  • Phone: 270-365-0300
  • Fax: 270-365-0413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number29000
License Number StateKY

VIII. Authorized Official

Name: MR. CHARLES D LOVELL JR.
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 270-365-0300