Provider Demographics
NPI:1558729228
Name:T J HEALTH COLUMBIA INC
Entity Type:Organization
Organization Name:T J HEALTH COLUMBIA INC
Other - Org Name:T J HEALTH COLUMBIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-651-4159
Mailing Address - Street 1:1301 N RACE ST
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-3454
Mailing Address - Country:US
Mailing Address - Phone:270-651-4444
Mailing Address - Fax:270-651-4892
Practice Address - Street 1:901 WESTLAKE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-1123
Practice Address - Country:US
Practice Address - Phone:270-384-7516
Practice Address - Fax:270-384-0583
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:T J REGIONAL HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-09
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100437310Medicaid
KY18S149Medicare PIN