NPIMap

Organization Active NPI

Marshall County Hosp District

  • Institutional Pharmacy
  • Benton, KY
National Provider Identifier
1003921032
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
P05109 Issued in KY
Legal business name
MARSHALL COUNTY HOSP DISTRICT
Practice address
615 Old Symsonia Rd
Benton, KY 42025-5042
Phone
(270) 527-4885
Fax
(270) 527-4893
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Phyllis Blackwell, RPH
Title
Chief Clinical Officer
Phone
(270) 527-4800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Institutional Pharmacy 3336I0012X P05109 KY Primary

Addresses

Primary practice location

615 Old Symsonia Rd
Benton, KY 42025-5042

Mailing address

PO Box 630
Benton, KY 42025-0630
Phone (270) 527-4800

Other identifiers 2

IdentifierTypeStateIssuer
2030096OtherPK
54025473MedicaidKY

Other names 1

  • MARSHALL COUNTY HOSPITAL PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Marshall County Hospital and Long Term Care Facility4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487808000000",
    "number": "1003921032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420250630",
            "telephone_number": "270-527-4800",
            "fax_number": "270-527-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 OLD SYMSONIA RD",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420255042",
            "telephone_number": "270-527-4885",
            "fax_number": "270-527-4893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHALL COUNTY HOSP DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2017-02-23",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "270-527-4800",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "KY",
            "license": "P05109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2030096",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54025473",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARSHALL COUNTY HOSPITAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.