Basic Information
| Provider Information | |||||||||
| NPI: | 1679660393 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ST. CLAIRE MEDICAL CENTER DBA BATH COUNTY MEDICAL CLINIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 968 | ||||||||
| Address2: | |||||||||
| City: | MOREHEAD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403510968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6067836521 | ||||||||
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| Practice Location | |||||||||
| Address1: | 632 SLATE AVENUE | ||||||||
| Address2: | |||||||||
| City: | OWINGSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6066746386 | ||||||||
| FaxNumber: | 6066743096 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2006 | ||||||||
| LastUpdateDate: | 06/28/2019 | ||||||||
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| AuthorizedOfficialLastName: | LLOYD | ||||||||
| AuthorizedOfficialFirstName: | DONALD | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 6067836501 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | II | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0002X | P01413 | KY | N | Suppliers | Pharmacy | Clinic Pharmacy | 332B00000X | P01413 | KY | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.