Provider Demographics
NPI:1265479513
Name:NHC HEALTHCARE-GLASGOW LLC
Entity Type:Organization
Organization Name:NHC HEALTHCARE-GLASGOW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-736-9581
Mailing Address - Street 1:109 HOMEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-3468
Mailing Address - Country:US
Mailing Address - Phone:270-651-6126
Mailing Address - Fax:
Practice Address - Street 1:109 HOMEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-3468
Practice Address - Country:US
Practice Address - Phone:270-651-6126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-02
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100015314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY12504619Medicaid
KY000000206105OtherANTHEM BCBS
185093Medicare Oscar/Certification