Provider Demographics
NPI:1154329696
Name:NORTON HOSPITALS INC
Entity Type:Organization
Organization Name:NORTON HOSPITALS INC
Other - Org Name:NORTON DIAGNOSTIC CENTER- DUPONT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP MANAGED CARE
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-272-5335
Mailing Address - Street 1:PO BOX 776788
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-5070
Mailing Address - Country:US
Mailing Address - Phone:502-629-8000
Mailing Address - Fax:
Practice Address - Street 1:3901 DUTCHMANS LN
Practice Address - Street 2:SUITE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4722
Practice Address - Country:US
Practice Address - Phone:502-896-2120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTON HOSPITALS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-08
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY01012764Medicaid
KY01012764Medicaid