Provider Demographics
NPI:1902862824
Name:THE JAMES B. HAGGIN MEMORIAL HOSPITAL INC
Entity Type:Organization
Organization Name:THE JAMES B. HAGGIN MEMORIAL HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:SNAPP
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:859-239-2424
Mailing Address - Street 1:464 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-1882
Mailing Address - Country:US
Mailing Address - Phone:859-734-5441
Mailing Address - Fax:859-734-5563
Practice Address - Street 1:464 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-1882
Practice Address - Country:US
Practice Address - Phone:859-734-5441
Practice Address - Fax:859-734-5563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY600053282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY12503181Medicaid
KY1008044Medicaid
KY12700308Medicaid
KY34002865Medicaid
18-7153Medicare ID - Type UnspecifiedMEDICARE PROV.#-HHA
KY34002865Medicaid
KY1008044Medicaid
KY12503181Medicaid