Provider Demographics
NPI:1174988836
Name:THE JAMES B. HAGGIN MEMORIAL HOSPITAL INC.
Entity type:Organization
Organization Name:THE JAMES B. HAGGIN MEMORIAL HOSPITAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:SNAPP
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:859-239-2424
Mailing Address - Street 1:466 LINDEN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-1841
Mailing Address - Country:US
Mailing Address - Phone:859-734-5173
Mailing Address - Fax:
Practice Address - Street 1:466 LINDEN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-1841
Practice Address - Country:US
Practice Address - Phone:859-734-5173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY600053363LF0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1008044Medicaid
181302Medicare PIN