NPIMap

Organization Active NPI

Russell Co Hospital Medical Arts Lab

  • Clinical Medical Laboratory
  • Russell Springs, KY
National Provider Identifier
1982809695
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
RUSSELL CO HOSPITAL MEDICAL ARTS LAB
Practice address
92 Joe T Petty Dr
Russell Springs, KY 42642-8544
Phone
(270) 866-9333
NPI assigned
Jun 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Authorized official

Name
Nequila Norris
Title
Director of Finance
Phone
(270) 858-6936

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

92 Joe T Petty Dr
Russell Springs, KY 42642-8544

Mailing address

PO Box 1610
Russell Springs, KY 42642-1610
Phone (270) 866-2016

Other identifiers 1

IdentifierTypeStateIssuer
37000882MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Russell Co Hospital8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

92 Joe T Petty Dr
Russell Springs, KY 42642
Phone (270) 866-7611

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1982809695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1610",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426421610",
            "telephone_number": "270-866-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 JOE T PETTY DR",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426428544",
            "telephone_number": "270-866-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL CO HOSPITAL MEDICAL ARTS LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "NORRIS",
        "authorized_official_first_name": "NEQUILA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "270-858-6936"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37000882",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russell Springs, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.