Provider Demographics
NPI:1962873109
Name:MARSHALL COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:MARSHALL COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:FUQUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-527-4850
Mailing Address - Street 1:619 OLD SYMSONIA RD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-5094
Mailing Address - Country:US
Mailing Address - Phone:270-527-2411
Mailing Address - Fax:270-527-8734
Practice Address - Street 1:619 OLD SYMSONIA RD
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-5094
Practice Address - Country:US
Practice Address - Phone:270-527-2411
Practice Address - Fax:270-527-8734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health