MEMORIAL HOSPITAL INC NPI 1104443654

NPI Information

  • NPI: 1104443654
  • Provider Name: MEMORIAL HOSPITAL INC
  • Classification: General Acute Care Hospital - 282NR1301X
  • Specialization: Rural
  • Entity Type: Organization
  • Other Name: ADVENTHEALTH SPORTS MED AND REHAB RED BIRD
  • CLIA Number: 18D0323887
  • Address: 53 QUEENDALE CTR STE 200
    BEVERLY, KY
    ZIP 40913
  • Phone: (606) 598-4525

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NPI Details

MEMORIAL HOSPITAL INC is a rural general acute care hospital in Beverly, KY. MEMORIAL HOSPITAL INC NPI is 1104443654. The provider is registered as an organization entity type.
The provider Other Name Is Adventhealth Sports Med And Rehab Red Bird.

The provider's business location address is:

53 QUEENDALE CTR STE 200
BEVERLY, KY
ZIP 40913-608
Phone: (606) 598-4525
Fax: (606) 599-2549

The provider's authorized official is Christopher Self .
The authorized official title is Ceo and has the following contact phone number (606) 598-5104.

The CLIA number assigned to this NPI record is 18D0323887 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/1/2020 and was last updated on 1/13/2021.

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
1282NR1301XGeneral Acute Care HospitalRuralYes

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: 11/21/2025

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