Organization
RUSSELL CO HOSPITAL MEDICAL ARTS LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEQUILA NORRIS (DIRECTOR OF FINANCE)
(270) 858-6936
Entity
Organization
Contact information
Practice address
92 JOE T PETTY DR, RUSSELL SPRINGS, KY 42642-8544
(270) 866-9333
Mailing address
PO BOX 1610, RUSSELL SPRINGS, KY 42642-1610
(270) 866-2016
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37000882
—
KY
Enumeration date
06/21/2007
Last updated
06/10/2024
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