OrganizationMemorial Hospital, Inc.(Mountain Medical Associates)Family MedicineAllopathic & Osteopathic PhysiciansPractice Address94 Marie Langdon Dr, Manchester, KY 40962-6353(606) 598-5104PECOS EnrollmentBased on the most recent information from CMS, provider Memorial Hospital, Inc. 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 yesterday at 3:36 PM.Profile DetailsProvider ID1447470539Provider TypeOrganizationFull NameMemorial Hospital, Inc.Other NameMountain Medical AssociatesSubpartNoEnumeration Date4/30/2007Last Updated1/13/2021Contact InformationPractice LocationPractice Address94 Marie Langdon Dr, Manchester, KY 40962-6353Phone(606) 598-5104Fax(606) 598-6507Mailing LocationMailing Address509 Memorial Dr, Manchester, KY 40962-6195Phone(606) 598-5104Fax(606) 598-6507Authorized OfficialNameNolen, Benny (Vice President)Phone(606) 598-5104Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID31001134DescriptionMedicaidIssuerUnlistedKentuckyIDCC2941DescriptionOtherIssuerRAILROAD MEDICAREKentucky