Healthcare Provider Details

I. General information

NPI: 1295930683
Provider Name (Legal Business Name): IRELAND ARMY COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 04/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 IRELAND AVE
FORT KNOX KY
40121-2722
US

IV. Provider business mailing address

289 IRELAND AVE ATTN: TREASURERS OFFICE
FORT KNOX KY
40121-5111
US

V. Phone/Fax

Practice location:
  • Phone: 502-624-9670
  • Fax:
Mailing address:
  • Phone: 502-624-9274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1100X
TaxonomyMilitary/U.S. Coast Guard Outpatient Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BARBARA HORNBACK
Title or Position: UBO MANAGER
Credential:
Phone: 502-624-9870