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	314000000X	Skilled Nursing Facility	100374	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4030140001	OTHER	KY	DME
2	54027149	OTHER	KY	SNF PHARMACY
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	90005547	OTHER	KY	DME

General Provider Information

NPI Number	:	1457324246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKCASTLE COUNTY HOSPITAL, INC.

Provider Business Mailing Address
First Line	:	145 NEWCOMB AVE
Second Line	:	PO BOX 1310
City	:	MOUNT VERNON
State	:	KY
Zip	:	40456-2733
Country	:	US
Telephone Number	:	606-256-2195
Fax Number	:	606-256-3947

Provider Business Practice Location Address
First Line	:	145 NEWCOMB AVE
Second Line	:
City	:	MOUNT VERNON
State	:	KY
Zip	:	40456-2733
Country	:	US
Telephone Number	:	606-256-2195
Fax Number	:

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

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	09/12/2013

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