Provider Demographics
NPI:1588930374
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:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:606-256-7745
Mailing Address - Street 1:160 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MT. VERNON
Mailing Address - State:KY
Mailing Address - Zip Code:40456
Mailing Address - Country:US
Mailing Address - Phone:606-256-2961
Mailing Address - Fax:606-256-3562
Practice Address - Street 1:160 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MT. VERNON
Practice Address - State:KY
Practice Address - Zip Code:40456
Practice Address - Country:US
Practice Address - Phone:606-256-2961
Practice Address - Fax:606-256-3562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17377207Q00000X
KY900253261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty