Healthcare Provider Details

I. General information

NPI: 1073504981
Provider Name (Legal Business Name): MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 09/10/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 POPLAR ST
MURRAY KY
42071-2432
US

IV. Provider business mailing address

803 POPLAR ST
MURRAY KY
42071-2432
US

V. Phone/Fax

Practice location:
  • Phone: 270-762-1100
  • Fax: 270-767-3657
Mailing address:
  • Phone: 270-762-1100
  • Fax: 270-767-3657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number100053
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberP05053
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. KITTY REGINA DAVISON
Title or Position: ARRA COORDINATOR
Credential:
Phone: 270-762-1273