Healthcare Provider Details

I. General information

NPI: 1154303113
Provider Name (Legal Business Name): BARREN COUNTY HEALTH CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 WESTWOOD ST
GLASGOW KY
42141
US

IV. Provider business mailing address

300 WESTWOOD ST
GLASGOW KY
42141
US

V. Phone/Fax

Practice location:
  • Phone: 270-651-9131
  • Fax: 270-651-6989
Mailing address:
  • Phone: 270-651-9131
  • Fax: 270-651-6989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number100509
License Number StateKY

VIII. Authorized Official

Name: MR. FREDERICK STEVE BROWN
Title or Position: ADMINISTRATOR/PRESIDENT
Credential: NURSING HOME ADMINIS
Phone: 270-651-9131