Provider Demographics
NPI:1073567608
Name:CUMBERLAND COUNTY HOSPITAL ASSOCIATION INC
Entity Type:Organization
Organization Name:CUMBERLAND COUNTY HOSPITAL ASSOCIATION INC
Other - Org Name:CUMBERLAND COUNTY HOSPITAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIKIRK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-864-2511
Mailing Address - Street 1:299 GLASGOW RD
Mailing Address - Street 2:P O BOX 280
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717-9696
Mailing Address - Country:US
Mailing Address - Phone:270-864-2511
Mailing Address - Fax:270-864-1306
Practice Address - Street 1:299 GLASGOW RD
Practice Address - Street 2:
Practice Address - City:BURKESVILLE
Practice Address - State:KY
Practice Address - Zip Code:42717-9696
Practice Address - Country:US
Practice Address - Phone:270-864-2511
Practice Address - Fax:270-864-1307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY600068207P00000X, 207Q00000X, 207R00000X, 207RP1001X, 207W00000X, 2085R0202X, 275N00000X, 282NC0060X, 341600000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No275N00000XHospital UnitsMedicare Defined Swing Bed UnitGroup - Multi-Specialty
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78903432Medicaid
KY01015833Medicaid
KY12700498Medicaid
KY65903296Medicaid
KY01015833Medicaid
KY55029011Medicaid
KY18Z317Medicare PIN