| Community Health Group Llc | |
|
2932 Breckenridge Ln Ste 5 Louisville KY 40220-1490 | |
| (502) 371-9703 | |
| (502) 540-3070 |
| Full Name | Community Health Group Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2932 Breckenridge Ln Ste 5, Louisville, Kentucky |
| Authorized Official Name and Position | Mohammad Ali Haider (OWNER) |
| Authorized Official Contact | 5026400124 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Group Llc 2932 Breckenridge Ln Ste 5 Louisville KY 40220-1490 Ph: (502) 371-9703 | Community Health Group Llc 2932 Breckenridge Ln Ste 5 Louisville KY 40220-1490 Ph: (502) 371-9703 |
| NPI Number | 1639925753 |
|---|---|
| Provider Enumeration Date | 04/29/2024 |
| Last Update Date | 04/29/2024 |
| Certification Date | 04/29/2024 |
| Medicare PECOS PAC ID | 3375085707 |
|---|---|
| Medicare Enrollment ID | O20240612003541 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639925753 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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