Provider Demographics
NPI:1669803375
Name:EPHRAIM MCDOWELL HEALTH RESOURCE, INC
Entity type:Organization
Organization Name:EPHRAIM MCDOWELL HEALTH RESOURCE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO/VP
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLLIAM
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 1:105 PONDER CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-9050
Mailing Address - Country:US
Mailing Address - Phone:859-236-4216
Mailing Address - Fax:
Practice Address - Street 1:105 PONDER CT
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-9050
Practice Address - Country:US
Practice Address - Phone:859-236-4216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty