Provider Demographics
NPI:1457324246
Name:ROCKCASTLE COUNTY HOSPITAL, INC.
Entity Type:Organization
Organization Name:ROCKCASTLE COUNTY HOSPITAL, INC.
Other - Org Name:ROCKCASTLE REGIONAL HOSPITAL AND RESPIRATORY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:BASTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-256-2195
Mailing Address - Street 1:145 NEWCOMB AVE
Mailing Address - Street 2:PO BOX 1310
Mailing Address - City:MOUNT VERNON
Mailing Address - State:KY
Mailing Address - Zip Code:40456-2733
Mailing Address - Country:US
Mailing Address - Phone:606-256-2195
Mailing Address - Fax:606-256-3947
Practice Address - Street 1:145 NEWCOMB AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:KY
Practice Address - Zip Code:40456-2733
Practice Address - Country:US
Practice Address - Phone:606-256-2195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100374314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4030140001OtherDME
KY54027149OtherSNF PHARMACY
KY12502217Medicaid
KY90005547OtherDME
KY12502217Medicaid