=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255504700
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEMORIAL HOSPITAL, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2008
-----------------------------------------------------
Last Update Date | 01/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1881 S US HIGHWAY 25E
-----------------------------------------------------
City | BARBOURVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40906-7747
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-545-0400
-----------------------------------------------------
Fax | 606-545-0433
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1881 S US HIGHWAY 25E
-----------------------------------------------------
City | BARBOURVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40906-7747
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 606-545-0400
-----------------------------------------------------
Fax | 606-545-0331
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | NICHOLAS BEJARANO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 606-598-5104
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR1300X
-----------------------------------------------------
Taxonomy Name | Rural Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------