Healthcare Provider Details

I. General information

NPI: 1013954437
Provider Name (Legal Business Name): RUSSELL COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 DOWELL RD
RUSSELL SPRINGS KY
42642-4579
US

IV. Provider business mailing address

153 DOWELL RD
RUSSELL SPRINGS KY
42642-4579
US

V. Phone/Fax

Practice location:
  • Phone: 270-866-4753
  • Fax: 270-866-7148
Mailing address:
  • Phone: 270-858-6936
  • Fax: 270-866-7148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number100529
License Number StateKY

VIII. Authorized Official

Name: MRS. NEQUILA NORRIS
Title or Position: DIR OF FINANCE
Credential:
Phone: 270-858-6936