Provider Demographics
NPI: | 1104890714 |
---|---|
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: | MR |
Authorized Official - First Name: | CHRISTOPHER |
Authorized Official - Middle Name: | NICHOLAS |
Authorized Official - Last Name: | BASTIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 606-256-2195 |
Mailing Address - Street 1: | 145 NEWCOMB AVE |
Mailing Address - Street 2: | PO BOX 1310 |
Mailing Address - City: | MOUNT VERNON |
Mailing Address - State: | KY |
Mailing Address - Zip Code: | 40456-2733 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 606-256-2195 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 145 NEWCOMB AVE |
Practice Address - Street 2: | |
Practice Address - City: | MOUNT VERNON |
Practice Address - State: | KY |
Practice Address - Zip Code: | 40456-2733 |
Practice Address - Country: | US |
Practice Address - Phone: | 606-256-2195 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-02-13 |
Last Update Date: | 2025-07-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
207R00000X, 341600000X, 363A00000X, 363L00000X | ||
KY | 100960 | 275N00000X, 332BP3500X, 367500000X, 282N00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 282N00000X | Hospitals | General Acute Care Hospital | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 275N00000X | Hospital Units | Medicare Defined Swing Bed Unit | ||
No | 332BP3500X | Suppliers | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition | Group - Multi-Specialty |
No | 341600000X | Transportation Services | Ambulance | Group - Multi-Specialty | |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
KY | 000000174204 | Other | BLUE CROSS BLUE SHIELD |
KY | 53J3 | Other | BLUE CROSS BLUE SHIELD |
KY | 000000174199 | Other | BLUE CROSS BLUE SHIELD |
KY | 12700480 | Medicaid | |
KY | 90005547 | Medicaid | |
KY | 50-00043 | Other | UNITED HEALTH CARE ACUTE |
KY | 65931818 | Medicaid | |
KY | 3900034 | Other | UNITED HEALTH CARE LABS |
KY | 000000061947 | Other | BLUE CROSS BLUE SHIELD |
KY | 000000054568 | Other | BLUE CROSS BLUE SHIELD |
KY | 01003425 | Medicaid | |
KY | 45000106 | Other | EPSDT |
KY | 31F1 | Other | BLUE CROSS BLUE SHIELD |
KY | 3500043 | Other | UNITED HEALTH CARE LABS |
KY | 000000054568 | Other | BLUE CROSS BLUE SHIELD |
KY | 53J3 | Other | BLUE CROSS BLUE SHIELD |
KY | 12700480 | Medicaid | |
KY | 0179 | Medicare PIN |