Provider Demographics
NPI:1922100122
Name:HOSPITAL OF FULTON INC
Entity Type:Organization
Organization Name:HOSPITAL OF FULTON INC
Other - Org Name:HILLVIEW MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR PHYSICIAN OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ARWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-628-6038
Mailing Address - Street 1:PO BOX 1320
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:KY
Mailing Address - Zip Code:42041-0320
Mailing Address - Country:US
Mailing Address - Phone:270-472-1612
Mailing Address - Fax:270-472-2095
Practice Address - Street 1:2006 HOLIDAY LN
Practice Address - Street 2:SUITE 100
Practice Address - City:FULTON
Practice Address - State:KY
Practice Address - Zip Code:42041-8468
Practice Address - Country:US
Practice Address - Phone:270-472-1612
Practice Address - Fax:270-472-2095
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITAL OF FULTON INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-01
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207P00000X, 207R00000X, 208000000X, 261QR1300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY35000181Medicaid
KYCF7864Medicare PIN
KY8275Medicare PIN