Provider Demographics
NPI:1780688333
Name:CALDWELL COUNTY HOSPITAL, INC
Entity Type:Organization
Organization Name:CALDWELL COUNTY HOSPITAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:270-365-0300
Mailing Address - Street 1:PO BOX 410
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:KY
Mailing Address - Zip Code:42445-0410
Mailing Address - Country:US
Mailing Address - Phone:270-365-0300
Mailing Address - Fax:270-365-0332
Practice Address - Street 1:101 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:KY
Practice Address - Zip Code:42445-2301
Practice Address - Country:US
Practice Address - Phone:270-365-0300
Practice Address - Fax:270-365-0332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2083X0100X, 225100000X, 235Z00000X
KY600072282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000054479OtherBLUE CROSS
KY01006931Medicaid
KY000000054480OtherBLUE CROSS SWINGBED
KY=========OtherTAX ID NUMBER
KY181322Medicare Oscar/Certification
KY000000054479OtherBLUE CROSS