# MEMORIAL HOSPITAL, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** AdventHealth Wound Care At Manchester, AdventHealth Medical Group Manchester
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912137720
- **Authorized official:** MRS. SISSEL JACOB (CEO)
- **Authorized official phone:** (606) 598-5104

## Contact information

- **Practice address:** 515 MEMORIAL DR STE 1, MANCHESTER, KY 40962-9157
- **Practice address phone:** (606) 598-4524
- **Practice address fax:** (606) 599-2554
- **Mailing address:** 210 MARIE LANGDON DR, MANCHESTER, KY 40962-6388
- **Mailing address phone:** (606) 598-5104

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/15/2009
- **Last updated:** 02/09/2023