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Organization

CASEY COUNTY PRIMARY CARE NURSING GROUP

Active
Parent organization
CASEY COUNTY HOSPITAL DISTRICT
Organization subpart
Yes

Provider details

NPI number
Legal business name
CASEY COUNTY HOSPITAL DISTRICT
Authorized official
REX A TUNGATE (CEO, ADMINISTRATOR)
(270) 384-4753
Entity
Organization

Contact information

Practice address
187 WOLFORD AVE, LIBERTY, KY 42539-3278
(606) 787-8348
(606) 787-9717
Mailing address
187 WOLFORD AVE, LIBERTY, KY 42539-3278
(606) 787-8348
(606) 787-9717

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7890229300
KY
Enumeration date
03/27/2008
Last updated
03/27/2008
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