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General NPI Number Information
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NPI Number | 1104012541
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Entity Type | Organization
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Legal Business Name | HOSPITAL OF FULTON INC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 2000 HOLIDAY LN
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City | FULTON
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State | KY
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Zip | 42041-8468
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Country | US
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Telephone | 270-472-2522
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 60985
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City | SAINT LOUIS
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State | MO
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Zip | 63160-0001
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Country | US
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Telephone | 270-472-2522
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, BUSINESS OFFICE SUPPORT
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Name | LAURIE HOLTSFORD
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Credential |
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Telephone | 615-465-7466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 900017
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License Number State | KY
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