Provider Demographics
NPI:1114937208
Name:CUMBERLAND COUNTY HOSPITAL ASSOCIATION INC
Entity Type:Organization
Organization Name:CUMBERLAND COUNTY HOSPITAL ASSOCIATION INC
Other - Org Name:B.F. TAYLOR MEDICAL ARTS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RICK
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:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717-0280
Mailing Address - Country:US
Mailing Address - Phone:270-864-2511
Mailing Address - Fax:270-864-1768
Practice Address - Street 1:299A GLASGOW RD
Practice Address - Street 2:
Practice Address - City:BURKESVILLE
Practice Address - State:KY
Practice Address - Zip Code:42717
Practice Address - Country:US
Practice Address - Phone:270-864-2555
Practice Address - Fax:270-864-3777
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CUMBERLAND COUNTY HOSPITAL ASSOCIATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-09
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY900136261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000243241OtherBCBS EKKLECTONIC BILLING
KY35001304Medicaid
KY35001304Medicaid