Provider Demographics
NPI:1023019130
Name:MS COMMUNITY HEALTH LLC
Entity Type:Organization
Organization Name:MS COMMUNITY HEALTH LLC
Other - Org Name:MUHLENBERG MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-377-1650
Mailing Address - Street 1:1010 MEDICAL CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:POWDERLY
Mailing Address - State:KY
Mailing Address - Zip Code:42367
Mailing Address - Country:US
Mailing Address - Phone:270-377-1600
Mailing Address - Fax:270-388-0229
Practice Address - Street 1:1010 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:POWDERLY
Practice Address - State:KY
Practice Address - Zip Code:42367
Practice Address - Country:US
Practice Address - Phone:270-377-1600
Practice Address - Fax:270-388-0229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY35002054Medicaid
KY6524Medicare PIN
KY35002054Medicaid