OrganizationMemorial Hospital, Inc.(Clay County Primary Care Center)Family MedicineAllopathic & Osteopathic PhysiciansPractice Address509 Memorial Dr, Suite 2, Manchester, KY 40962-6195(606) 598-8813PECOS 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 today at 11:36 AM.Profile DetailsProvider ID1457592693Provider TypeOrganizationFull NameMemorial Hospital, Inc.Other NameClay County Primary Care CenterSubpartNoEnumeration Date3/18/2009Last Updated1/13/2021Contact InformationPractice LocationPractice Address509 Memorial Dr, Suite 2, Manchester, KY 40962-6195Phone(606) 598-8813Fax(606) 598-0983Mailing LocationMailing Address509 Memorial Dr, Suite 2, Manchester, KY 40962-6195Phone(606) 598-8813Fax(606) 598-0983Authorized OfficialNameNolen, Benny (Vice President)Phone(606) 598-5104Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID31001134DescriptionMedicaidIssuerUnlistedKentuckyIDCC2941DescriptionOtherIssuerRR MEDICARE