MEMORIAL HOSPITAL INC (NPI# 1104443654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104443654 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL INC |
| Practice Address |
53 Queendale Ctr Ste 200 Beverly KY 40913-9608 |
| Practice Telephone | 6065984525 |
| Practice Fax Number | 6065992549 |
| Mailing Telephone | 6065984525 |
| Mailing Fax Number | 6065992549 |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2020-07-01 |
| Authorized Official Name | CHRISTOPHER SELF (CEO) |
| Authorized Official Telephone | 6065985104 |
| Is Organization Subpart | Y |
| Parent Organization Name | ADVENTHEALTH SUNBELT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
Hospitals |
| Other Name | Type Code |
|---|---|
| AdventHealth Sports Med and Rehab Red Bird | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023649514 | Memorial Hospital Inc | Clinic/Center | 485 Memorial Dr Ste 1, Manchester, KY 40962-9111 | 2020-02-03 |
| 1194744664 | Memorial Hospital Inc | Supports Brokerage | 94 Marie Langdon Dr Ste 6, Manchester, KY 40962-6345 | 2006-07-18 |
| 1477184968 | Memorial Hospital Inc | Clinic/Center | 515 Memorial Dr Ste 2, Manchester, KY 40962-9157 | 2020-02-03 |
| 1801270962 | Memorial Hospital Inc | Non-Pharmacy Dispensing Site | 502 E Elm Dr, Loyal, WI 54446-9604 | 2015-07-17 |
| 1821472986 | Memorial Hospital Inc | Non-Pharmacy Dispensing Site | 216 Sunset Pl, Neillsville, WI 54456-1706 | 2015-07-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | MEMORIAL HOSPITAL INCORPORATED | L.b. & B. Building, Waynesboro, Virginia 22980 |
| Street Address |
53 QUEENDALE CTR STE 200 |
| City | BEVERLY |
| State | KY |
| Zip Code | 40913-9608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821084971 | Red Bird Clinic, Inc. | Clinic/Center | 53 Queendale Center, Suite 1, Beverly, KY 40913 | 2005-09-23 |
| 1780683219 | Red Bird Volunteer Fire and Rescue Inc | Ambulance | 31 Queendale Ctr, Beverly, KY 40913-9602 | 2005-07-18 |
| 1790771046 | Millard Lynn Fogleman | Family Medicine | 53 Queendale Ctr, Red Bird Clinic, Beverly, KY 40913-9607 | 2005-09-22 |
| 1083030860 | Aaron N. Frye | Nurse Practitioner | 53 Queendale Ctr, Beverly, KY 40913-9608 | 2014-03-17 |
| 1558665752 | Memorial Hospital, Inc. | Family Medicine | 53 Queendale Ctr, Beverly, KY 40913-9608 | 2011-01-03 |
| 1992815419 | Rx Discount Pharmacy of Harlan Inc | Pharmacy | 53 Queendale Ctr, Hc 69 Box 701, Beverly, KY 40913-9608 | 2006-08-30 |
| 1053421560 | Bruce D. Polly | Pharmacist | 53 Queendale Ctr, Beverly, KY 40913-9608 | 2006-08-30 |
| 1609862952 | Sharon Kay Goodwin Fogleman | Family Medicine | 53 Queendale Ctr, Red Bird Clinic, Beverly, KY 40913-9608 | 2005-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548050 | Elizabeth Karen Turner | Physical Therapist | 800 Cummings Ctr Ste 147u, Beverly, MA 01915-6172 | 2020-11-07 |
| 1235730151 | Jennifer Beardslee | Psychologist | 116 Bridge St, Beverly, MA 01915-2851 | 2020-11-06 |
| 1730780370 | Helena Santos-martins, Md, PC | Internal Medicine | 100 Cummings Ctr Ste 106-q, Beverly, MA 01915-6115 | 2020-11-02 |
| 1225638398 | Nicholas Makogonov | Behavior Technician | 4 Kinsman St, Beverly, MA 01915-1819 | 2020-10-28 |
| 1124626726 | Lov Home Care LLC | In Home Supportive Care | 498 Elliott St, Beverly, MA 01915-2331 | 2020-10-15 |
| 1962000703 | Jonathan Inz Phd LLC | Psychologist | 100 Cummings Ctr Ste 453, Beverly, MA 01915-6115 | 2020-10-14 |
| 1922605344 | Anchor Home Medical, Inc | Durable Medical Equipment & Medical Supplies | 409 Cabot St Ste 8, Beverly, MA 01915-3175 | 2020-10-08 |
| 1124625892 | Steven M Adkison | Registered Nurse | 197 Lothrop St, Beverly, MA 01915-3763 | 2020-10-06 |
| 1083221352 | Myeyedr Optometry of Massachusetts P C | Optometrist | 495 Cabot St Ste 1, Beverly, MA 01915-2515 | 2020-09-30 |
| 1104433614 | Holly Welch | Technician | 5 Dixie St, Beverly, WV 26253-8935 | 2020-09-29 |
| Find all providers in BEVERLY | ||||
| Taxonomy Code | 282NR1301X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Rural |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619038247 | Lake Cumberland Regional Hospital LLC | General Acute Care Hospital | 305 Langdon Street, Somerset, KY 42502 | 2006-12-13 |
| 1316939689 | Clinton County Hospital, Inc. | General Acute Care Hospital | 723 Burkesville Rd, Albany, KY 42602-1654 | 2005-08-22 |
| 1992701429 | Saint Joseph Health System Inc | General Acute Care Hospital | 1001 Saint Joseph Ln, London, KY 40741-8345 | 2005-06-21 |
| 1013379528 | The Medical Center At Clinton County, Inc. | General Acute Care Hospital | 723 Burkesville Rd, Albany, KY 42602-1654 | 2016-03-23 |
| 1487976163 | H. Eduardo Pavon M.d. | General Acute Care Hospital | 298 Main St, Suite 2, Cadiz, KY 42211-9155 | 2010-02-22 |
| 1699941427 | St Claire Regional Medical Center | General Acute Care Hospital | 445 Clinic Dr, Morehead, KY 40351-1077 | 2008-05-01 |
| 1558585091 | Ccmh Corporation | General Acute Care Hospital | 309 11th St, Carrollton, KY 41008-1435 | 2007-04-13 |
| 1063549814 | Murray Calloway County Public Hospital Corporation | General Acute Care Hospital | 803 Poplar St, Murray, KY 42071-2432 | 2007-02-28 |
| 1780746420 | Spring View Hospital LLC | General Acute Care Hospital | 320 Loretto Rd, Lebanon, KY 40033-1300 | 2006-12-15 |
| 1326107319 | Georgetown Community Hospital LLC | General Acute Care Hospital | 1140 Lexington Rd, Georgetown, KY 40324-9330 | 2006-12-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.