MEDICARE: BOWLING GREEN-WARREN COUNTY COMMUNITY HOSPITAL CORPORATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363LF0000X	Family Nurse Practitioner
2	207Q00000X	Family Medicine Physician
3	261QR1300X	Rural Health Clinic/Center

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

General Provider Information

NPI Number	:	1760228647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOWLING GREEN-WARREN COUNTY COMMUNITY HOSPITAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 117924
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30368-7924
Country	:	US
Telephone Number	:	270-726-7664
Fax Number	:	270-726-9997

Provider Business Practice Location Address
First Line	:	1719 NASHVILLE ST STE C
Second Line	:
City	:	RUSSELLVILLE
State	:	KY
Zip	:	42276-7804
Country	:	US
Telephone Number	:	270-726-7664
Fax Number	:	270-726-9997

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT & CFO
Name	:	MICHELE LAWLESS
Credential	:
Telephone Number	:	270-745-1500

Provider Enumeration Date	:	07/01/2024
Last Update Date	:	06/06/2026

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