MEDICARE: ROCKCASTLE COUNTY HOSPITAL, 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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1184197386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKCASTLE COUNTY HOSPITAL, INC.

Provider Business Mailing Address
First Line	:	75 NEWCOMB AVE
Second Line	:
City	:	MOUNT VERNON
State	:	KY
Zip	:	40456-2732
Country	:	US
Telephone Number	:	606-256-7695
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 NEWCOMB AVE
Second Line	:
City	:	MOUNT VERNON
State	:	KY
Zip	:	40456-2732
Country	:	US
Telephone Number	:	606-256-7695
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	CHRISTOPHER NICHOLAS BASTIN
Credential	:
Telephone Number	:	606-256-2195

Provider Enumeration Date	:	01/10/2019
Last Update Date	:	01/10/2019

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