Provider Demographics
NPI:1104890714
Name:ROCKCASTLE COUNTY HOSPITAL INC
Entity type:Organization
Organization Name:ROCKCASTLE COUNTY HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:BASTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-256-2195
Mailing Address - Street 1:145 NEWCOMB AVE
Mailing Address - Street 2:PO BOX 1310
Mailing Address - City:MOUNT VERNON
Mailing Address - State:KY
Mailing Address - Zip Code:40456-2733
Mailing Address - Country:US
Mailing Address - Phone:606-256-2195
Mailing Address - Fax:
Practice Address - Street 1:145 NEWCOMB AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:KY
Practice Address - Zip Code:40456-2733
Practice Address - Country:US
Practice Address - Phone:606-256-2195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X, 363A00000X, 341600000X, 363L00000X
KY100960275N00000X, 332BP3500X, 367500000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral NutritionGroup - Multi-Specialty
No341600000XTransportation ServicesAmbulanceGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000061947OtherBLUE CROSS BLUE SHIELD
KY000000174204OtherBLUE CROSS BLUE SHIELD
KY90005547Medicaid
KY000000054568OtherBLUE CROSS BLUE SHIELD
KY12700480Medicaid
KY000000174199OtherBLUE CROSS BLUE SHIELD
KY45000106OtherEPSDT
KY01003425Medicaid
KY3500043OtherUNITED HEALTH CARE LABS
KY31F1OtherBLUE CROSS BLUE SHIELD
KY53J3OtherBLUE CROSS BLUE SHIELD
KY3900034OtherUNITED HEALTH CARE LABS
KY50-00043OtherUNITED HEALTH CARE ACUTE
KY65931818Medicaid
KY000000054568OtherBLUE CROSS BLUE SHIELD
KY53J3OtherBLUE CROSS BLUE SHIELD
KY12700480Medicaid
KY0179Medicare PIN