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General NPI Number Information
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NPI Number | 1346247962
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Entity Type | Organization
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Legal Business Name | JACKSON HOSPITAL CORPORATION
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Dates
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Enumeration Date | 06/29/2005
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 540 JETT DR
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City | JACKSON
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State | KY
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Zip | 41339-9622
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Country | US
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Telephone | 606-666-6000
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Fax | 606-666-6102
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Provider Business Mailing Address
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Address Line | 540 JETTS DRIVE
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City | JACKSON
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State | KY
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Zip | 41339-9622
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Country | US
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Telephone | 606-666-6000
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Fax | 606-666-6102
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Authorized Official
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Title or Position | SVP FINANCE OPERATIONS
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Name | RANDY MICHAEL COOPER
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Credential |
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Telephone | 615-221-3840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 100620
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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