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Organization
PINELAKE REGIONAL HOSPITAL LLC
Active
Organization
PINELAKE REGIONAL HOSPITAL LLC
Active
Other names
Jackson Purchase Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE LAWRENCE (SECRETARY)
(615) 920-7688
Entity
Organization
Contact information
Practice address
1099 MEDICAL CENTER CIR, MAYFIELD, KY 42066-1159
(270) 251-4100
(270) 251-4507
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7000
(615) 920-8913
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
100143
KY
282NR1301X
Rural Acute Care Hospital
Primary
100143
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000055031
BCBS
KY
01
—
000000061925
BCBS REFERENCE LAB
KY
05
—
01000116
—
KY
01
—
030016699
USEC DEPT. OF LABOR
KY
01
—
360503
BLACK LUNG
KY
Enumeration date
09/20/2006
Last updated
01/15/2026
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