| Memorial Hospital, Inc. | |
|
53 Queendale Ctr Ste 2 Beverly KY 40913-8621 | |
| (606) 598-5135 | |
| (606) 599-2525 |
| Full Name | Memorial Hospital, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 53 Queendale Ctr Ste 2, Beverly, Kentucky |
| Authorized Official Name and Position | Sissel Jacob (CEO) |
| Authorized Official Contact | 6065985104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Memorial Hospital, Inc. 210 Marie Langdon Dr Manchester KY 40962-6388 Ph: (606) 598-5104 | Memorial Hospital, Inc. 53 Queendale Ctr Ste 2 Beverly KY 40913-8621 Ph: (606) 598-5135 |
| NPI Number | 1558665752 |
|---|---|
| Provider Enumeration Date | 01/03/2011 |
| Last Update Date | 02/09/2023 |
| Medicare PECOS PAC ID | 4486616141 |
|---|---|
| Medicare Enrollment ID | O20130620000577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558665752 | NPI | - | NPPES |
| 7100312760 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |