OrganizationMemorial Hospital(Physician Services Of Memorial Hospital)Family MedicineAllopathic & Osteopathic PhysiciansPractice Address210 Marie Langdon Dr, Manchester, KY 40962-6388(606) 598-5104PECOS EnrollmentBased on the most recent information from CMS, provider Memorial Hospital does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:36 AM.Profile DetailsProvider ID1245370824Provider TypeOrganizationFull NameMemorial HospitalOther NamePhysician Services Of Memorial HospitalSubpartNoEnumeration Date2/6/2007Last Updated1/13/2021Contact InformationPractice LocationPractice Address210 Marie Langdon Dr, Manchester, KY 40962-6388Phone(606) 598-5104Fax(606) 599-0983Mailing LocationMailing Address210 Marie Langdon Dr, Manchester, KY 40962-6388Phone(606) 598-5104Fax(606) 599-0983Authorized OfficialNameNolen, Benny (Vice President)Phone(606) 598-5104Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense900134Kentucky