Organization
COMMONWEALTH OF KENTUCKY
Active
Parent organization
COMMONWEALTH OF KENTUCKY
Other names
Eastern State Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF KENTUCKY
Authorized official
JENNIFER MOORE (ASSISTANT DIRECTOR)
(502) 782-6117
Entity
Organization
Contact information
Practice address
1350 BULL LEA RD, LEXINGTON, KY 40511-1247
(859) 246-8000
(859) 246-8043
Mailing address
1350 BULL LEA RD, LEXINGTON, KY 40511-1247
(859) 246-8000
(859) 246-8043
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
KY
283Q00000X
Psychiatric Hospital
—
—
3336I0012X
Institutional Pharmacy
P06579
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02020030
—
KY
Enumeration date
03/08/2007
Last updated
08/07/2024
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