Healthcare Provider Details

I. General information

NPI: 1265076947
Provider Name (Legal Business Name): CALDWELL COUNTY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2019
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CASSIDY AVE
FREDONIA KY
42411-9207
US

IV. Provider business mailing address

PO BOX 410
PRINCETON KY
42445-0410
US

V. Phone/Fax

Practice location:
  • Phone: 270-545-3386
  • Fax: 270-365-4152
Mailing address:
  • Phone: 270-545-3386
  • Fax: 270-365-4152

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: TERESA L. CARPENTER
Title or Position: DIRECTOR
Credential:
Phone: 270-365-0238