Provider Demographics
NPI:1548215437
Name:TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORPORATION
Entity Type:Organization
Organization Name:TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORPORATION
Other - Org Name:TAYLOR COUNTY HOME SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:G
Authorized Official - Last Name:WHEATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-465-3561
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42719-0270
Mailing Address - Country:US
Mailing Address - Phone:270-465-6341
Mailing Address - Fax:270-789-5883
Practice Address - Street 1:1700 OLD LEBANON RD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-9662
Practice Address - Country:US
Practice Address - Phone:270-465-6341
Practice Address - Fax:270-789-5883
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-23
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY150109251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY34010918Medicaid
KY00000054660OtherBLUE CROSS PROVIDER
KY42011098Medicaid
KY187105Medicare ID - Type UnspecifiedMEDICARE