Provider Demographics
NPI:1700043981
Name:ST. CLAIRE REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:ST. CLAIRE REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:606-783-6502
Mailing Address - Street 1:1028 E MAIN ST
Mailing Address - Street 2:PO BOX 1098
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-1328
Mailing Address - Country:US
Mailing Address - Phone:606-783-6961
Mailing Address - Fax:606-783-6966
Practice Address - Street 1:1028 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-1328
Practice Address - Country:US
Practice Address - Phone:606-783-6961
Practice Address - Fax:606-783-6966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000553166OtherBLUE CROSS
KY31000326Medicaid
KY31000326Medicaid