Healthcare Provider Details

I. General information

NPI: 1518240969
Provider Name (Legal Business Name): EPHRAIM MCDOWELL HEALTH RESOURCE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2011
Last Update Date: 01/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 DANVILLE ST
LANCASTER KY
40444-1150
US

IV. Provider business mailing address

PO BOX 990
DANVILLE KY
40423-0990
US

V. Phone/Fax

Practice location:
  • Phone: 859-792-2124
  • Fax: 859-239-6898
Mailing address:
  • Phone: 859-239-2360
  • Fax: 859-239-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM M SNAPP III
Title or Position: CFO
Credential:
Phone: 859-239-2424