LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES INC. NPI 1669612008

NPI Information

NPI: 1669612008
Provider Name: LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC.

Doing Business As: GRAND LAKES CLINIC

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1860 J.H. O'BRYAN AVE.
GRAND RIVERS, KY
ZIP 42045
Phone: (270) 362-8246
Get Directions

LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC. is a multi-specialty clinic center in Grand Rivers, KY. LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC. NPI is 1669612008. The provider is registered as an organization entity type.
The provider Is Doing Business As Grand Lakes Clinic.

The provider's business location address is:

1860 J.H. O'BRYAN AVE.
GRAND RIVERS, KY
ZIP 42045
Phone: (270) 362-8246
Fax: (270) 362-9757

The provider's authorized official is Mark A Edwards .
The authorized official title is Administrator//ceo and has the following contact phone number (270) 988-7235.

The CLIA number assigned to this NPI record is 18D0979196 - rural health clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/25/2009 and was last updated on 8/5/2011.

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	261QM1300X	Clinic/Center	Multi-Specialty	900135	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	0761701	MEDICARE PIN	KENTUCKY
2	7617	MEDICARE PIN	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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