Healthcare Provider Details

I. General information

NPI: 1831213651
Provider Name (Legal Business Name): CRITTENDEN COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 W GUM ST
MARION KY
42064-1516
US

IV. Provider business mailing address

520 W GUM ST P.O. BOX 386
MARION KY
42064-1516
US

V. Phone/Fax

Practice location:
  • Phone: 270-965-1042
  • Fax: 270-965-1061
Mailing address:
  • Phone: 270-965-1042
  • Fax: 270-965-1061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number100080
License Number StateKY

VIII. Authorized Official

Name: MR. THOMAS M HALES
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 270-965-1042