Healthcare Provider Details

I. General information

NPI: 1730668419
Provider Name (Legal Business Name): THE JAMES B. HAGGIN MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1541 LEBANON RD STE 1
DANVILLE KY
40422-8349
US

IV. Provider business mailing address

PO BOX 990
DANVILLE KY
40423-0990
US

V. Phone/Fax

Practice location:
  • Phone: 859-236-3208
  • Fax: 859-239-7991
Mailing address:
  • Phone: 859-239-2360
  • Fax: 859-239-6785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMANDA KINMAN
Title or Position: CFO
Credential:
Phone: 859-239-2424