Organization
PINELAKE REGIONAL HOSPITAL LLC
Active
Other names
Jackson Purchase Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE LAWRENCE (SECRETARY)
(615) 920-7688
Entity
Organization
Contact information
Practice address
1099 MEDICAL CENTER CIR, MAYFIELD, KY 42066-1159
(270) 251-4100
(270) 251-4507
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7000
(615) 920-8913
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
100143
KY
282NR1301X
Rural Acute Care Hospital
Primary
100143
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000055031
BCBS
KY
01
—
000000061925
BCBS REFERENCE LAB
KY
05
—
01000116
—
KY
01
—
030016699
USEC DEPT. OF LABOR
KY
01
—
360503
BLACK LUNG
KY
Enumeration date
09/20/2006
Last updated
01/15/2026
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