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General NPI Number Information
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NPI Number | 1528255692
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Entity Type | Organization
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Legal Business Name | CCMH CORPORATION
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 309 11TH ST
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City | CARROLLTON
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State | KY
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Zip | 41008-1435
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Country | US
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Telephone | 502-732-3299
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Fax |
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Provider Business Mailing Address
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Address Line | 309 11TH ST
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City | CARROLLTON
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State | KY
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Zip | 41008-1435
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Country | US
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Telephone | 502-732-3243
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Fax | 502-732-3297
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | SHEILA TOMLINSON
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Credential |
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Telephone | 502-732-3278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | KY
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