Provider Demographics
NPI:1053885392
Name:CRITTENDEN COMMUNITY HOSPITAL LLC
Entity type:Organization
Organization Name:CRITTENDEN COMMUNITY HOSPITAL LLC
Other - Org Name:<UNAVAIL>
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 1:520 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:270-965-1042
Mailing Address - Fax:270-965-1061
Practice Address - Street 1:520 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:270-965-1042
Practice Address - Fax:270-965-1061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-21
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
No282N00000XHospitalsGeneral Acute Care Hospital