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Organization

MEMORIAL HOSPITAL, INC.

Active
Other names
AdventHealth Red Bird Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
SISSEL JACOB (CEO)
(606) 598-5104
Entity
Organization

Contact information

Practice address
53 QUEENDALE CTR STE 2, BEVERLY, KY 40913-8621
(606) 598-5135
(606) 599-2525
Mailing address
210 MARIE LANGDON DR, MANCHESTER, KY 40962-6388
(606) 598-5104

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
261QR1300X
Rural Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100312760
KY
Enumeration date
01/03/2011
Last updated
02/09/2023
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