Provider Demographics
NPI:1689761942
Name:TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORPORATION
Entity Type:Organization
Organization Name:TAYLOR COUNTY HOSPITAL DISTRICT HEALTH FACILITIES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:SABO, JR.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-789-5785
Mailing Address - Street 1:1700 OLD LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-9615
Mailing Address - Country:US
Mailing Address - Phone:270-465-3561
Mailing Address - Fax:270-789-5882
Practice Address - Street 1:1700 OLD LEBANON RD
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-9615
Practice Address - Country:US
Practice Address - Phone:270-465-3561
Practice Address - Fax:270-789-5882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100394282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000072489OtherANTHEM PROFESSIONAL ID#
KY1061503OtherPASSPORT ID#
KY000000054661OtherANTHEM TECHNICAL ID#
KY000000061960OtherANTHEM LAB ID#
KY01021039Medicaid
KY2434238000OtherPASSPORT ADVANTAGE ID#
KY5000074OtherUNITED HEALTHCARE ID#
KY000000072489OtherANTHEM PROFESSIONAL ID#