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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