OrganizationMemorial Hospital, Inc.(Family Medical Care Of Clay County)Family MedicineAllopathic & Osteopathic PhysiciansPractice Address94 Marie Langdon Dr, Suite 1, 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 today at 11:36 AM.Profile DetailsProvider ID1609040179Provider TypeOrganizationFull NameMemorial Hospital, Inc.Other NameFamily Medical Care Of Clay CountySubpartNoEnumeration Date4/16/2008Last Updated1/13/2021Contact InformationPractice LocationPractice Address94 Marie Langdon Dr, Suite 1, Manchester, KY 40962-6353Phone(606) 598-5104FaxUnlisted FaxMailing LocationMailing Address509 Memorial Drive, Suite 2, Manchester, KY 40962-6195Phone(606) 598-5104Fax(606) 598-0983Authorized OfficialNameNolen, Benny (Vice President)Phone(606) 598-5104Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID31001134DescriptionMedicaidIssuerUnlistedKentuckyID65934523DescriptionMedicaidIssuerUnlistedKentuckyIDCC2941DescriptionOtherIssuerRR MEDICARE