BREATITT COUNTY GERIATRIC CORPORATION NPI 1669542825

NPI Information

NPI: 1669542825
Provider Name: BREATITT COUNTY GERIATRIC CORPORATION

Doing Business As: NIM HENSON GERIATRIC CENTER

Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization

Address:
420 JETT DR
JACKSON, KY
ZIP 41339
Phone: (606) 666-2456
Get Directions

BREATITT COUNTY GERIATRIC CORPORATION is a durable medical equipment medical supplies in Jackson, KY. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. BREATITT COUNTY GERIATRIC CORPORATION NPI is 1669542825. The provider is registered as an organization entity type.
The provider Is Doing Business As Nim Henson Geriatric Center.

The provider's business location address is:

420 JETT DR
JACKSON, KY
ZIP 41339-621
Phone: (606) 666-2456
Fax: (606) 666-9376

The provider's authorized official is Phillip Litteral .
The authorized official title is Administrator and has the following contact phone number (606) 666-2456.

The CLIA number assigned to this NPI record is 18D0886864 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/8/2006 and was last updated on 7/17/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	314000000X	Skilled Nursing Facility		KY100040	KENTUCKY	No
2	332B00000X	Durable Medical Equipment & Medical Supplies		KY100040	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0827770001	MEDICARE NSC	KENTUCKY
2	185112	MEDICARE ID-TYPE UNSPECIFIED	KENTUCKY
3	9013013900	MEDICAID	KENTUCKY
4	543892824	OTHER	KENTUCKY	BLACK LUNG
5	000000054703	OTHER	KENTUCKY	BLUE CROSS BLUE SHIELD
6	12501524	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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