IRELAND ARMY COMMUNITY HOSPITAL NPI 1104032754

NPI Information

NPI: 1104032754
Provider Name: IRELAND ARMY COMMUNITY HOSPITAL
Classification: Clinic/Center - 261QM1100X
Specialization: Military/U.S. Coast Guard Outpatient
Entity Type: Organization
Doing Business As: BLUE GRASS DEPOT AHC
CLIA Number: 18D2241710
Address: 2091 KINGSTON HWY
ATTN BLUE GRASS HEALTH CLINIC
RICHMOND, KY
ZIP 40475
Phone: (502) 624-9333

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NPI Details

IRELAND ARMY COMMUNITY HOSPITAL is a military/u.s. coast guard outpatient clinic center in Richmond, KY. The provider is the Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. IRELAND ARMY COMMUNITY HOSPITAL NPI is 1104032754. The provider is registered as an organization entity type.
The provider Is Doing Business As Blue Grass Depot Ahc.

The provider's business location address is:

2091 KINGSTON HWY
ATTN BLUE GRASS HEALTH CLINIC
RICHMOND, KY
ZIP 40475-000
Phone: (502) 624-9333

The provider's authorized official is Barbara Hornback .
The authorized official title is Ubo Manager and has the following contact phone number (502) 624-9870.

The CLIA number assigned to this NPI record is 18D2241710 - other - residential facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/14/2007 and was last updated on 4/1/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1100X	Clinic/Center	Military/U.S. Coast Guard Outpatient			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier Issuer
1	VAD000	MEDICARE UPIN
2	1891899274	OTHER	PARENT FACILITY IRELAND ACH NPI
3	OTH000	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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