# LOGAN MEMORIAL HOSPITAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Logan Memorial Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992893416
- **Authorized official:** JOHNETTA TRAYLOR (AO)
- **Authorized official phone:** (502) 596-6063

## Contact information

- **Practice address:** 1625 NASHVILLE ST, RUSSELLVILLE, KY 42276-8853
- **Practice address phone:** (270) 726-4011
- **Practice address fax:** (270) 726-7465
- **Mailing address:** 680 S 4TH ST \# KH-3, LOUISVILLE, KY 40202-2407
- **Mailing address phone:** (502) 596-6063

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NR1301X | Rural Acute Care Hospital | 73 | KY | Yes |

## Other

- **Enumeration date:** 10/10/2006
- **Last updated:** 06/24/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000055027 | BLUE CROSS | KY |
| 01 | — | 000000342028 | BLUE CROSS LABORATORY | KY |
| 05 | — | 01000132 | — | KY |
| 05 | — | 0180066 | — | TN |
| 05 | — | 100038770A | — | IN |
| 01 | — | 1096575 | PASSPORT HEALTH | KY |
| 01 | — | 166291400 | ACS | KY |
| 01 | — | 360698 | BLACK LUNG | KY |
| 01 | — | 5000013 | UNITED HEALTHCARE | KY |
| 01 | — | KYMCO11B | WORKERS COMP | KY |