Provider Demographics
NPI:1013957620
Name:ST. CLAIRE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:ST. CLAIRE MEDICAL CENTER, INC.
Other - Org Name:ST. CLAIRE HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
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 1:707 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-1321
Mailing Address - Country:US
Mailing Address - Phone:606-784-6747
Mailing Address - Fax:606-784-7071
Practice Address - Street 1:707 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-1321
Practice Address - Country:US
Practice Address - Phone:606-784-6747
Practice Address - Fax:606-784-7071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000069963OtherBCBS
KY040733100OtherBLACK LUNG
KY90031030Medicaid
KY91477OtherABP ADMINISTRATION
KY80624OtherNORTHWOOD
KY9175OtherCHA
KY040733100OtherBLACK LUNG