Provider Demographics
NPI:1821135963
Name:EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER INCORPORATED
Entity Type:Organization
Organization Name:EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER INCORPORATED
Other - Org Name:EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-239-1000
Mailing Address - Street 1:PO BOX 1108
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40423-1108
Mailing Address - Country:US
Mailing Address - Phone:853-893-1000
Mailing Address - Fax:
Practice Address - Street 1:217 S 3RD ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1823
Practice Address - Country:US
Practice Address - Phone:859-239-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100034282N00000X
333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY01010552Medicaid
KY01010552Medicaid