Provider Demographics
NPI:1992286207
Name:CALDWELL COUNTY HOSPITAL, INC
Entity type:Organization
Organization Name:CALDWELL COUNTY HOSPITAL, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICIER
Authorized Official - Prefix:
Authorized Official - First Name:MICAH
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:CONGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-365-0320
Mailing Address - Street 1:PO BOX 410
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:KY
Mailing Address - Zip Code:42445-0410
Mailing Address - Country:US
Mailing Address - Phone:270-365-1225
Mailing Address - Fax:270-365-1252
Practice Address - Street 1:302 MICBETH DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:KY
Practice Address - Zip Code:42445-6332
Practice Address - Country:US
Practice Address - Phone:270-365-1225
Practice Address - Fax:270-365-1252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health