Provider Demographics
NPI:1831923291
Name:EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER, INCORPORATED
Entity type:Organization
Organization Name:EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARM.D.
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:VICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-239-1706
Mailing Address - Street 1:150 WAR ADMIRAL STE 1
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-8690
Mailing Address - Country:US
Mailing Address - Phone:859-239-3535
Mailing Address - Fax:
Practice Address - Street 1:150 WAR ADMIRAL STE 1
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-8690
Practice Address - Country:US
Practice Address - Phone:859-239-3535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP08354Other(NON-MEDICARE)