Provider Demographics
NPI:1043604812
Name:T J SAMSON COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:T J SAMSON COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-651-4334
Mailing Address - Street 1:PO BOX 645996
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-5996
Mailing Address - Country:US
Mailing Address - Phone:270-651-4401
Mailing Address - Fax:270-651-4607
Practice Address - Street 1:310 N L ROGERS WELLS BLVD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-1300
Practice Address - Country:US
Practice Address - Phone:270-651-1111
Practice Address - Fax:270-651-4607
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:T J REGIONAL HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-19
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy