Provider Demographics
NPI:1700989217
Name:BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION
Other - Org Name:THE MEDICAL CENTER AT SCOTTSVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXEC. VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:SOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-745-1500
Mailing Address - Street 1:456 BURNLEY RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42164-6355
Mailing Address - Country:US
Mailing Address - Phone:270-622-2846
Mailing Address - Fax:270-622-2811
Practice Address - Street 1:456 BURNLEY RD
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164
Practice Address - Country:US
Practice Address - Phone:270-622-2846
Practice Address - Fax:270-622-2811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP05202282NC0060X, 314000000X, 333600000X, 3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY12503116Medicaid
KY54032743Medicaid