Organization
PAINTSVILLE HOSPITAL COMPANY, LLC
Active
Other names
Paul B Hall Regional 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
625 JAMES TRIMBLE BLVD, PAINTSVILLE, KY 41240-1055
(606) 789-3511
Mailing address
625 JAMES TRIMBLE BLVD, PAINTSVILLE, KY 41240-1055
(606) 789-3511
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
282N00000X
General Acute Care Hospital
Primary
100269
KY
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054471
KY BLUE CROSS
KY
05
—
01010750
—
KY
Enumeration date
06/12/2006
Last updated
08/11/2020
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