MEDICARE: GRAYSON COUNTY HOSPITAL FOUNDATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant
2	235Z00000X	Speech-Language Pathologist
3	282N00000X	General Acute Care Hospital	100151	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000054565	OTHER	KY	ANTHEM PROVIDER #
5	1048799	OTHER	KY	PASSPORT
6	2432221000	OTHER	KY	PASSPORT ADVANTAGE

General Provider Information

NPI Number	:	1114929494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRAYSON COUNTY HOSPITAL FOUNDATION INC

Provider Business Mailing Address
First Line	:	910 WALLACE AVE
Second Line	:
City	:	LEITCHFIELD
State	:	KY
Zip	:	42754-1418
Country	:	US
Telephone Number	:	270-259-9400
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 WALLACE AVE
Second Line	:
City	:	LEITCHFIELD
State	:	KY
Zip	:	42754-1418
Country	:	US
Telephone Number	:	270-259-9400
Fax Number	:	270-259-9524

Authorized Official
Title or Position	:	REIMBURSEMENT ANALYST
Name	:	CYNTHIA R BAILEY
Credential	:
Telephone Number	:	270-259-1656

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	02/19/2019

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Directions to “GRAYSON COUNTY HOSPITAL FOUNDATION INC ” Practice Location

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