Provider Demographics
NPI:1093711178
Name:NORTON HOSPITALS, INC
Entity Type:Organization
Organization Name:NORTON HOSPITALS, INC
Other - Org Name:NORTON SOUTHWEST MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:GOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-629-8326
Mailing Address - Street 1:PO BOX 35070
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40232-5070
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9700 STONESTREET RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-2884
Practice Address - Country:US
Practice Address - Phone:502-933-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTON HOSPITALS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-23
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100475261Q00000X, 261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000061919OtherANTHEM REF LAB PROV NUM
1049531OtherPASSPORT PROV NUMBER
000000297478OtherANTHEM IMPLANTS PROV NUM
000000054676OtherANTHEM ACUTE PROV NUMBER
KY01012764Medicaid
0474137OtherAETNA HMO PROV NUMBER
5000015OtherUNITED HEALTHCARE PROV
000000297478OtherANTHEM IMPLANTS PROV NUM
000000054676OtherANTHEM ACUTE PROV NUMBER
KY01012764Medicaid