Provider Demographics
NPI:1265076947
Name:CALDWELL COUNTY HOSPITAL INC
Entity type:Organization
Organization Name:CALDWELL COUNTY HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:ODEGAARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-365-0321
Mailing Address - Street 1:PO BOX 410
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:KY
Mailing Address - Zip Code:42445-0410
Mailing Address - Country:US
Mailing Address - Phone:270-545-3386
Mailing Address - Fax:270-545-3712
Practice Address - Street 1:700 CASSIDY AVE
Practice Address - Street 2:
Practice Address - City:FREDONIA
Practice Address - State:KY
Practice Address - Zip Code:42411-9207
Practice Address - Country:US
Practice Address - Phone:270-545-3386
Practice Address - Fax:270-545-3712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health