OrganizationMemorial Hospital(<Unavail>)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 2 days ago.Profile DetailsProvider ID1245370824Provider TypeOrganizationFull NameMemorial HospitalOther Name<Unavail>SubpartNoEnumeration 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