Provider Demographics
NPI:1558490789
Name:NORTON HOSPITALS INC
Entity Type:Organization
Organization Name:NORTON HOSPITALS INC
Other - Org Name:NORTON WOMENS AND CHILDRENS HOSPITAL REFERENCE LAB
Other - Org Type:Other Name
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 1:4001 DUTCHMANS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4714
Practice Address - Country:US
Practice Address - Phone:502-893-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTON WOMENS AND CHILDRENS HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-05
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100255291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000061962OtherANTHEM REFLAB
180088Medicare Oscar/Certification