MEMORIAL HOSPITAL INC (NPI# 1194744664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194744664 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL INC |
| Other Organization Name | MEMORIAL HOSPITAL HOME HEALTH |
| Practice Address |
94 Marie Langdon Dr Ste 6 Manchester KY 40962-6345 |
| Mailing Address |
210 Marie Langdon Dr Manchester KY 40962-6388 |
| Practice Telephone | 6065981969 |
| Practice Fax Number | 6065982062 |
| Mailing Telephone | 6065981969 |
| Mailing Fax Number | 6065982062 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-09-18 |
| Authorized Official Name | GARY CARLSON (CFO) |
| Authorized Official Telephone | 6065985104 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEMORIAL HOSPITAL INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251X00000X | Supports Brokerage | Agencies | ||
| Y | 251E00000X | Home Health | 150039 | KY | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | MEDICAID TENNESSEE | 1004431 | 01 |
| KY | MEDICAID PENDING | 100443100 | 01 |
| KY | 4200280 | 05 | |
| KY | BLUE CROSS BLUE SHIELD KY | 000000054585 | 01 |
| KY | MEDICARE MANAGED CARE | 180043 | 01 |
| KY | MEMORIAL EMPLOYEES | 65265 | 01 |
| IN | INDIANA MEDICAID | 100033950A | 01 |
| KY | UNITED HEALTHCARE | 5000038 | 01 |
| KY | ANTHEM BLUE CROSS | 65265 | 01 |
| OH | MEDICAID OHIO | A87696 | 01 |
| KY | PASSPOST HEALTH PLAN | 100443100 | 01 |
| KY | 34002808 | 05 | |
| KY | AETNA | 0005154214 | 01 |
| KY | BLACK LUNG | 30523000 | 01 |
| WV | BLUE CROSS BLUE SHIELD WV | 001703971 | 01 |
| WV | BRICK STREET MTL WV WC | 1038912 | 01 |
| Other Name | Type Code |
|---|---|
| AdventHealth Home Care Manchester | Doing Business As Name - Organization |
| Memorial Hospital Home Health | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 210 Marie Langdon Dr, Manchester, KY 409626388 | 6065985104 | 6065982062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104443654 | Memorial Hospital Inc | General Acute Care Hospital | 53 Queendale Ctr Ste 200, Beverly, KY 40913-9608 | 2020-07-01 |
| 1023649514 | Memorial Hospital Inc | Clinic/Center | 485 Memorial Dr Ste 1, Manchester, KY 40962-9111 | 2020-02-03 |
| 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 |
94 MARIE LANGDON DR STE 6 |
| City | MANCHESTER |
| State | KY |
| Zip Code | 40962-6345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609392356 | Angela Woods | Speech-Language Pathologist | 96 Woods Rd, Manchester, KY 40962 | 2017-08-15 |
| 1346627296 | Betty Alevras | Nurse Practitioner | 21 Crestview Drive, 204 Town Branch Road, Manchester, KY 40962 | 2015-04-29 |
| 1740525773 | Clay Community Pharmacy LLC | Pharmacy | 118 Clay Co S/c, Manchester, KY 40962 | 2012-12-03 |
| 1669758579 | Becky F Stubblefield | Nurse Practitioner | 65 Glenndale Drive, Manchester, KY 40962 | 2011-10-25 |
| 1891022315 | Sabrina Nicole Hacker | Occupational Therapist | 376 Manchester Square Shopping Centre, Manchester, KY 40962 | 2009-11-04 |
| 1114102167 | H&n Drug | Durable Medical Equipment & Medical Supplies | 515 Memorial Dr., Suite 2, Manchester, KY 40962 | 2008-01-08 |
| 1598944043 | Cumberland Valley Dist. Health Dept | Public Health or Welfare | 1983 Hwy 421, Manchester, KY 40962 | 2007-11-01 |
| 1023223203 | Dinah Lynn Sowders | Speech-Language Pathologist | 561 Mill Pond Drive, Manchester, KY 40962 | 2007-05-11 |
| 1104965300 | American Health Management, Inc. | Case Management | 2609 Hwy 80, Manchester, KY 40962 | 2007-02-05 |
| 1306902572 | Manchester Pharmacist Group LLC | Durable Medical Equipment & Medical Supplies | 415 Richmond Road, Unit B, Manchester, KY 40962 | 2006-12-29 |
| Find all providers in zip 40962 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
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| 1558913616 | One Harmony Health Care LLC | Home Health | 128 Enchanted Pkwy Ste 205, Manchester, MO 63021-5497 | 2019-07-09 |
| 1093376386 | Secure Home Healthcare Services LLC | Home Health | 134 Enchanted Pkwy Ste 203, Manchester, MO 63021-5495 | 2019-06-26 |
| 1396300364 | Always Best Care Senior Services of Central Connecticut Inc | Home Health | 135 Center St, Manchester, CT 06040-5006 | 2019-05-06 |
| 1184198210 | Care for You Home Care LLC | Home Health | 142 Enchanted Pkwy Ste 100a, Manchester, MO 63021-5412 | 2019-01-11 |
| 1629540349 | On Call Healthcare Professionals | Home Health | 1900 Route 70 Ste 9, Manchester, NJ 08759-4627 | 2018-12-19 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 40962 |
Please comment or provide details below to improve the information on MEMORIAL HOSPITAL INC.
| 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.