1629459912 NPI number — EPHRAIM MCDOWELL HEALTH RESOURCES,INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629459912 NPI number — EPHRAIM MCDOWELL HEALTH RESOURCES,INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EPHRAIM MCDOWELL HEALTH RESOURCES,INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629459912
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
230 W MAIN ST
Provider Second Line Business Mailing Address:
STE 102
Provider Business Mailing Address City Name:
DANVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40422-1871
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-236-9670
Provider Business Mailing Address Fax Number:
859-236-7656

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
92 JT PETTY DRIVE
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
RUSSELL SPRINGS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-236-9670
Provider Business Practice Location Address Fax Number:
859-236-7656
Provider Enumeration Date:
06/12/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SNAPP
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CFO/VP
Authorized Official Telephone Number:
859-239-2424

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com