Provider Demographics
NPI:1962090134
Name:CRITTENDEN COMMUNITY HOSPITAL LLC
Entity type:Organization
Organization Name:CRITTENDEN COMMUNITY HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DARREL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-527-1234
Mailing Address - Street 1:518 W GUM ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:KY
Mailing Address - Zip Code:42064-1516
Mailing Address - Country:US
Mailing Address - Phone:270-965-5238
Mailing Address - Fax:
Practice Address - Street 1:518 W GUM ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:KY
Practice Address - Zip Code:42064-1516
Practice Address - Country:US
Practice Address - Phone:270-965-5238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRITTENDEN COMMUNITY HOSPITAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health