=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932174968
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADAIR COUNTY HOSPITAL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2006
-----------------------------------------------------
Last Update Date | 11/06/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 810 JAMESTOWN ST
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42728-1010
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-384-4764
-----------------------------------------------------
Fax | 270-384-5826
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 810 JAMESTOWN ST
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42728-1010
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-384-4764
-----------------------------------------------------
Fax | 270-384-5826
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. NEAL M. GOLD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 270-384-4753
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR1300X
-----------------------------------------------------
Taxonomy Name | Rural Health Clinic/Center
-----------------------------------------------------
License Number | 7000034
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------