# MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Knott County Family Healthcare West
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376759563
- **Authorized official:** BENNY NOLEN (VICE PRESIDENT)
- **Authorized official phone:** (606) 598-5104

## Contact information

- **Practice address:** 86 SAVANNAH LANE, BULAN, KY 41722
- **Practice address phone:** (606) 598-5104
- **Practice address fax:** (606) 598-0983
- **Mailing address:** 509 MEMORIAL DR, MANCHESTER, KY 40962-6195
- **Mailing address phone:** (606) 598-5104
- **Mailing address fax:** (606) 598-0983

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/15/2007
- **Last updated:** 01/13/2021