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Organization
WESTLAKE PRIMARY CARE OF RUSSELL COUNTY NURSING GROUP
Active
Organization
WESTLAKE PRIMARY CARE OF RUSSELL COUNTY NURSING GROUP
Active
Parent organization
ADAIR COUNTY HOSPITAL DISTRICT
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADAIR COUNTY HOSPITAL DISTRICT
Authorized official
REX A TUNGATE (CEO, ADMINISTRATOR)
(270) 384-4753
Entity
Organization
Contact information
Practice address
2465 LAKEWAY DRIVE, RUSSELL SPRINGS, KY 42642
(270) 858-3636
(270) 858-3660
Mailing address
2465 LAKEWAY DRIVE, RUSSELL SPRINGS, KY 42642
(270) 858-3636
(270) 858-3660
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3234P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7890222800
—
KY
Enumeration date
03/26/2008
Last updated
03/26/2008
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