MEDICARE: ST. CLAIRE MEDICAL CENTER,INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	700050	KY
2	261QR1300X	Rural Health Clinic/Center	900057	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080025855	OTHER	KY	RAILROAD MEDICARE INDIV #
2	080187638	OTHER	KY	RAILROAD MEDICARE INDIV #
4	080113230	OTHER		RAILROAD MEDICARE INDIV #
6	080113207	OTHER	KY	RAILROAD MEDICARE INDIV #
8	080077589	OTHER	KY	RAILROAD MEDICARE INDIV #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	029858800	OTHER	KY	FEDERAL BLACK LUNG
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639131527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. CLAIRE MEDICAL CENTER,INC

Provider Business Mailing Address
First Line	:	PO BOX 1268
Second Line	:
City	:	OLIVE HILL
State	:	KY
Zip	:	41164-1268
Country	:	US
Telephone Number	:	606-286-4152
Fax Number	:	606-286-2385

Provider Business Practice Location Address
First Line	:	155 BRICKLAYER STREET
Second Line	:
City	:	OLIVE HILL
State	:	KY
Zip	:	41164
Country	:	US
Telephone Number	:	606-286-4152
Fax Number	:	606-283-2385

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	DONALD H LLOYD II
Credential	:
Telephone Number	:	606-783-6502

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	08/17/2023

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Directions to “ST. CLAIRE MEDICAL CENTER,INC ” Practice Location

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