Healthcare Provider Details

I. General information

NPI: 1124078696
Provider Name (Legal Business Name): ST CLAIRE MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 MEDICAL CIR
MOREHEAD KY
40351-1179
US

IV. Provider business mailing address

PO BOX 968
MOREHEAD KY
40351-0968
US

V. Phone/Fax

Practice location:
  • Phone: 606-783-6521
  • Fax: 606-783-6904
Mailing address:
  • Phone: 606-783-6521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number100377
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number100377
License Number StateKY

VIII. Authorized Official

Name: MR. DONALD H LLOYD II
Title or Position: CEO/ PRESIDENT
Credential:
Phone: 606-783-6502