Provider Demographics
NPI:1568729408
Name:MUHLENBERG COMMUNITY HOSPITAL INC
Entity Type:Organization
Organization Name:MUHLENBERG COMMUNITY HOSPITAL INC
Other - Org Name:TERRY D HOLT MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:COUNTZLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-338-8275
Mailing Address - Street 1:PO BOX 387
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42345-0387
Mailing Address - Country:US
Mailing Address - Phone:270-757-0014
Mailing Address - Fax:270-757-0020
Practice Address - Street 1:101 LEGION DR
Practice Address - Street 2:SUITE 3
Practice Address - City:CENTRAL CITY
Practice Address - State:KY
Practice Address - Zip Code:42330-1496
Practice Address - Country:US
Practice Address - Phone:270-757-0014
Practice Address - Fax:270-757-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-17
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY44957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00023Medicare PIN