Healthcare Provider Details

I. General information

NPI: 1619038247
Provider Name (Legal Business Name): LAKE CUMBERLAND REGIONAL HOSPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 LANGDON STREET
SOMERSET KY
42502
US

IV. Provider business mailing address

330 SEVEN SPRINGS WAY
BRENTWOOD TN
37027-5098
US

V. Phone/Fax

Practice location:
  • Phone: 606-676-2250
  • Fax: 606-451-0963
Mailing address:
  • Phone: 615-920-7000
  • Fax: 615-920-8913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number100959
License Number StateKY

VIII. Authorized Official

Name: CHARLOTTE LAWRENCE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7688