1881749927 NPI number — EPHRAIM MCDOWELL HEALTH RESOURCE, 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 1881749927 NPI number — EPHRAIM MCDOWELL HEALTH RESOURCE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EPHRAIM MCDOWELL HEALTH RESOURCE, 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:
1881749927
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 990
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DANVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40423-0990
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-239-2360
Provider Business Mailing Address Fax Number:
859-239-6898

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
280 LINCOLN DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40069-1516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-336-9801
Provider Business Practice Location Address Fax Number:
859-336-3080
Provider Enumeration Date:
01/25/2007

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
Authorized Official Telephone Number:
859-239-1000

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  900140 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1054929 . This is a "PASSPORT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 35001635 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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