Healthcare Provider Details

I. General information

NPI: 1992744536
Provider Name (Legal Business Name): WAYNE COUNTY HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 HOSPITAL ST
MONTICELLO KY
42633-2416
US

IV. Provider business mailing address

166 HOSPITAL ST
MONTICELLO KY
42633-2416
US

V. Phone/Fax

Practice location:
  • Phone: 606-348-9343
  • Fax: 606-340-3258
Mailing address:
  • Phone: 606-348-9343
  • Fax: 606-340-3258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02809
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number38039
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35830
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number600074
License Number StateKY
# 5
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number600074
License Number StateKY

VIII. Authorized Official

Name: MR. JOHN JOSEPH MURRELL
Title or Position: CEO
Credential:
Phone: 606-348-9343