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General NPI Number Information
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NPI Number | 1376586404
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Entity Type | Organization
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Legal Business Name | CAVERNA MEMORIAL HOSPITAL INC.
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 1501 S DIXIE ST
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City | HORSE CAVE
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State | KY
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Zip | 42749-1480
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Country | US
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Telephone | 270-786-2191
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Fax | 270-786-1557
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Provider Business Mailing Address
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Address Line | 1501 S DIXIE ST
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City | HORSE CAVE
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State | KY
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Zip | 42749-1480
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Country | US
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Telephone | 270-786-2191
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Fax | 270-786-1557
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Authorized Official
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Title or Position | CEO
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Name | MR. ALAN ALEXANDER
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Credential |
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Telephone | 270-786-2191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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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 | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 600065
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License Number State | KY
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