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Organization
CLARK REGIONAL MEDICAL CENTER, INC
Active
Organization
CLARK REGIONAL MEDICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT D FRARACCIO (CHIEF EXECUTIVE OFFICER)
(859) 745-3500
Entity
Organization
Contact information
Practice address
1107 W LEXINGTON AVE, WINCHESTER, KY 40391-1169
(859) 745-3500
(859) 745-3450
Mailing address
1107 W LEXINGTON AVE, WINCHESTER, KY 40391-1169
(859) 745-3500
(859) 745-3450
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100740
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054544
BLUE CROSS
KY
01
—
032043100
BLACK LUNG
KY
05
—
12503637
—
KY
Enumeration date
07/14/2006
Last updated
05/20/2010
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