Organization
HOSPITAL OF LOUISA, INC.
Active
Other names
Three Rivers Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY MICHAEL COOPER (SVP FINANCE OP/AUTHORIZED OFFICIAL)
(615) 221-3840
Entity
Organization
Contact information
Practice address
2485 HIGHWAY 644, LOUISA, KY 41230-9242
(606) 638-9451
(606) 638-9494
Mailing address
PO BOX 60990, SAINT LOUIS, MO 63160-0990
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
100282
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000065267
BCBS
—
05
—
0001027000
—
WV
01
—
000319438
MOUNTAIN STATE BC
—
05
—
01022292
—
KY
01
—
030527200
BLACK LUNG
—
05
—
0968681
—
OH
01
—
1069693
PASSPORT HLTH PLAN
—
01
—
129
ANTHEM BC
—
01
—
1457524
UMWA
—
Enumeration date
02/02/2006
Last updated
08/11/2020
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