Organization
1300 CAMPBELL LANE OPERATING COMPANY LLC
Active
Other names
Southern Kentucky Rehabilitation Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD EUGENE HOLLINGER (PRESIDENT)
(717) 591-5700
Entity
Organization
Contact information
Practice address
1300 CAMPBELL LN, BOWLING GREEN, KY 42104-4162
(270) 782-6900
(270) 782-7228
Mailing address
PO BOX 26657, FRESNO, CA 93729-6657
(559) 892-2500
(559) 892-2444
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
100655
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000273851
BLUE CROSS BLUE SHIELD
KY
05
—
01000272
—
KY
Enumeration date
05/22/2006
Last updated
09/06/2023
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