Provider Demographics
NPI:1639364201
Name:PATTIE A. CLAY INFIRMARY ASSN
Entity Type:Organization
Organization Name:PATTIE A. CLAY INFIRMARY ASSN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:OLDS
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE
Authorized Official - Phone:859-625-3299
Mailing Address - Street 1:P.O. BOX 1600
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40476-2603
Mailing Address - Country:US
Mailing Address - Phone:859-625-3299
Mailing Address - Fax:859-625-3535
Practice Address - Street 1:789 EASTERN BYP
Practice Address - Street 2:SUITE 25
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2415
Practice Address - Country:US
Practice Address - Phone:859-625-3299
Practice Address - Fax:859-625-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100322282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5771OtherMEDICARE GROUP