Healthcare Provider Details

I. General information

NPI: 1427034172
Provider Name (Legal Business Name): LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 08/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 HOSPITAL DR
SALEM KY
42078-8043
US

IV. Provider business mailing address

131 HOSPITAL DR
SALEM KY
42078-8043
US

V. Phone/Fax

Practice location:
  • Phone: 270-988-2299
  • Fax: 270-988-3900
Mailing address:
  • Phone: 270-988-2299
  • Fax: 270-988-3900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number600071
License Number StateKY

VIII. Authorized Official

Name: MR. MARK A EDWARDS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 270-988-2299