Provider Demographics
NPI:1154483253
Name:BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION
Other - Org Name:THE MEDICAL CENTER AT SCOTTSVILLE RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT/CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWLESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-745-1500
Mailing Address - Street 1:PO BOX 3560
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-3560
Mailing Address - Country:US
Mailing Address - Phone:270-618-3700
Mailing Address - Fax:270-618-3772
Practice Address - Street 1:466 BURNLEY RD
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164-6355
Practice Address - Country:US
Practice Address - Phone:270-618-3700
Practice Address - Fax:270-618-3772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY900204261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100016780Medicaid
KYCG1846OtherRAILROAD MEDICARE
KY000000508983OtherBLUE PREFERRED
KY000000508983OtherBLUE PREFERRED
KY7100016780Medicaid