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NPI Code Detail

MEDICARE: HILLCREST NURSING HOME OF CORBIN, INC.

MEDICARE: HILLCREST NURSING HOME OF CORBIN, 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
1314000000XSkilled Nursing Facility100425KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000054707OTHERKYANTHEM BCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962514380
Entity Type Code : Organization
Provider Name (Legal Business Name) : HILLCREST NURSING HOME OF CORBIN, INC.
Provider Business Mailing Address
First Line : PO BOX 556
Second Line :
City : CORBIN
State : KY
Zip : 40702-0556
Country : US
Telephone Number : 606-528-8917
Fax Number : 606-528-0070
Provider Business Practice Location Address
First Line : 1245 AMERICAN GREETING CARD RD
Second Line :
City : CORBIN
State : KY
Zip : 40701-4811
Country : US
Telephone Number : 606-528-8917
Fax Number : 606-528-0070
Authorized Official
Title or Position : CHAIRMAN
Name : MR. TERRY EMANUEL FORCHT
Credential :
Telephone Number : 606-528-9600
Provider Enumeration Date : 08/31/2006
Last Update Date : 05/07/2008

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