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General NPI Number Information
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NPI Number | 1639131527
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Entity Type | Organization
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Legal Business Name | ST. CLAIRE MEDICAL CENTER,INC
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 155 BRICKLAYER STREET
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City | OLIVE HILL
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State | KY
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Zip | 41164
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Country | US
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Telephone | 606-286-4152
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Fax | 606-283-2385
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Provider Business Mailing Address
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Address Line | PO BOX 1268
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City | OLIVE HILL
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State | KY
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Zip | 41164-1268
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Country | US
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Telephone | 606-286-4152
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Fax | 606-286-2385
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | DONALD H LLOYD II
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Credential |
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Telephone | 606-783-6502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 700050
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 900057
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License Number State | KY
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