Provider Demographics
NPI:1457553042
Name:PATTIE A CLAY REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:PATTIE A CLAY REGIONAL MEDICAL CENTER
Other - Org Name:PATTIE A CLAY HOSPITAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:859-625-3478
Mailing Address - Street 1:801 EASTERN BY-PASS
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475
Mailing Address - Country:US
Mailing Address - Phone:859-625-3533
Mailing Address - Fax:859-625-3541
Practice Address - Street 1:801 EASTERN BY-PASS
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475
Practice Address - Country:US
Practice Address - Phone:859-625-3533
Practice Address - Fax:859-625-3541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY180049Medicare ID - Type UnspecifiedPROVIDER NUMBER