Provider Demographics
NPI:1013379528
Name:THE MEDICAL CENTER AT CLINTON COUNTY, INC.
Entity Type:Organization
Organization Name:THE MEDICAL CENTER AT CLINTON COUNTY, INC.
Other - Org Name:THE MEDICAL CENTER AT ALBANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWLESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-745-1500
Mailing Address - Street 1:PO BOX 8000
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-8000
Mailing Address - Country:US
Mailing Address - Phone:606-387-6421
Mailing Address - Fax:606-387-8550
Practice Address - Street 1:723 BURKESVILLE RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:KY
Practice Address - Zip Code:42602-1654
Practice Address - Country:US
Practice Address - Phone:606-387-6421
Practice Address - Fax:606-387-8550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100078275N00000X, 282NR1301X
282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100415350Medicaid
KY000000995896OtherANTHEM
KY7100415350Medicaid