| |
100 W 3rd St Ste 207 Owensboro KY 42303-4135 | |
(270) 929-0162 | |
(270) 228-0341 |
Full Name | |
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Speciality | Social Worker |
Location | 100 W 3rd St Ste 207, Owensboro, Kentucky |
Authorized Official Name and Position | Christopher Chad Foster (OWNER) |
Authorized Official Contact | 2709290162 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4323 Plantation Pt Owensboro KY 42303-7808 Ph: (270) 313-8128 | 100 W 3rd St Ste 207 Owensboro KY 42303-4135 Ph: (270) 929-0162 |
NPI Number | 1881150241 |
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Provider Enumeration Date | 02/11/2019 |
Last Update Date | 05/22/2019 |
Medicare PECOS PAC ID | 6507109857 |
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Medicare Enrollment ID | O20190530000741 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881150241 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Christopher Chad Foster |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1679622740 PECOS PAC ID: 8123368248 Enrollment ID: I20190327000682 |
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