Provider Demographics
NPI:1598125502
Name:THE MEDICAL CENTER AT CLINTON COUNTY, INC.
Entity Type:Organization
Organization Name:THE MEDICAL CENTER AT CLINTON COUNTY, INC.
Other - Org Name:THE MEDICAL CENTER AT ALBANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWLESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-745-1500
Mailing Address - Street 1:PO BOX 8000
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-8000
Mailing Address - Country:US
Mailing Address - Phone:606-387-6421
Mailing Address - Fax:606-387-8550
Practice Address - Street 1:723 BURKESVILLE RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:KY
Practice Address - Zip Code:42602-1654
Practice Address - Country:US
Practice Address - Phone:606-387-6421
Practice Address - Fax:606-387-8550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282NC0060X, 282NC0060X
KY100078282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Multi-Specialty
No282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000995851OtherANTHEM
KY7100414740Medicaid
KY180106Medicare Oscar/Certification