Healthcare Provider Details

I. General information

NPI: 1831164789
Provider Name (Legal Business Name): ADAIR COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 11/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2465 LAKEWAY DRIVE
RUSSELL SPRINGS KY
42642-4510
US

IV. Provider business mailing address

PO BOX 2010
RUSSELL SPRINGS KY
42642-2010
US

V. Phone/Fax

Practice location:
  • Phone: 270-858-3636
  • Fax: 270-858-3660
Mailing address:
  • Phone: 270-858-3636
  • Fax: 270-858-3660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number700096
License Number StateKY

VIII. Authorized Official

Name: MR. NEAL M. GOLD
Title or Position: CEO
Credential:
Phone: 270-384-4753