Provider Demographics
NPI:1477287472
Name:HEBRON MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:HEBRON MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-486-3744
Mailing Address - Street 1:2091 N BEND RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-9691
Mailing Address - Country:US
Mailing Address - Phone:859-271-4730
Mailing Address - Fax:
Practice Address - Street 1:2091 N BEND RD
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-9691
Practice Address - Country:US
Practice Address - Phone:859-271-4730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty