Provider Demographics
NPI:1548526692
Name:EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER, INCORPORATED
Entity type:Organization
Organization Name:EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER, INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT AND 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 1:150 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1806
Mailing Address - Country:US
Mailing Address - Phone:859-239-1691
Mailing Address - Fax:859-239-6728
Practice Address - Street 1:68 HUSTONVILLE ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:42539-3469
Practice Address - Country:US
Practice Address - Phone:606-787-0468
Practice Address - Fax:606-787-0486
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER, INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-03
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100231900Medicaid
KY90020116Medicaid