Provider Demographics
NPI:1780573618
Name:EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER INCORPORATED
Entity type:Organization
Organization Name:EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-239-2424
Mailing Address - Street 1:343 N WALLACE WILKINSON BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:KY
Mailing Address - Zip Code:42539-3031
Mailing Address - Country:US
Mailing Address - Phone:606-448-6053
Mailing Address - Fax:606-448-6054
Practice Address - Street 1:343 N WALLACE WILKINSON BLVD STE 2
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:42539-3031
Practice Address - Country:US
Practice Address - Phone:606-448-6053
Practice Address - Fax:606-448-6054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy