Organization
MEMORIAL HOSPITAL, INC.
Active
Organization
MEMORIAL HOSPITAL, INC.
Active
Other names
Clay County Rural Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENNY NOLEN (VICE PRESIDENT)
(606) 598-5104
Entity
Organization
Contact information
Practice address
509 MEMORIAL DR, SUITE 2, MANCHESTER, KY 40962-6195
(606) 598-8813
(606) 599-0983
Mailing address
509 MEMORIAL DR, SUITE 2, MANCHESTER, KY 40962-6195
(606) 598-8813
(606) 599-0983
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030523000
BLACKLUNG
KY
01
—
080008321
RAILROAD MEDICARE
KY
01
—
533520561
TRICARE
KY
05
—
7100009090
—
KY
Enumeration date
03/10/2007
Last updated
01/13/2021
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