Provider Demographics
NPI:1891899274
Name:IRELAND ARMY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:IRELAND ARMY COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF, UBO
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNBACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-624-9870
Mailing Address - Street 1:289 IRELAND AVE
Mailing Address - Street 2:ATTN: TREASURERS OFFICE
Mailing Address - City:FORT KNOX
Mailing Address - State:KY
Mailing Address - Zip Code:40121-5111
Mailing Address - Country:US
Mailing Address - Phone:502-624-9870
Mailing Address - Fax:
Practice Address - Street 1:289 IRELAND AVE
Practice Address - Street 2:
Practice Address - City:FORT KNOX
Practice Address - State:KY
Practice Address - Zip Code:40121-5111
Practice Address - Country:US
Practice Address - Phone:502-624-9870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital
No261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient
No261QM1101XAmbulatory Health Care FacilitiesClinic/CenterMilitary and U.S. Coast Guard Ambulatory Procedure
Provider Identifiers
StateIdentifier IDID TypeIssuer
AN2598588OtherMEDCO
KY000000054883OtherUB92 BCBS KY HOSP ID
KY000000286728OtherCMS1500 BCBS KY HOSP
1826102OtherPHARMACY NCPDP
VAD000Medicare UPIN
KY000000054883OtherUB92 BCBS KY HOSP ID