| Louisville Integrated Care | |
|
1151 S 4th St Ste 208 Louisville KY 40203-3101 | |
| (502) 612-6981 | |
| Not Available |
| Full Name | Louisville Integrated Care |
|---|---|
| Speciality | Family Medicine |
| Location | 1151 S 4th St Ste 208, Louisville, Kentucky |
| Authorized Official Name and Position | Michelle R Hicks (OWNER) |
| Authorized Official Contact | 5026126981 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Louisville Integrated Care 1151 S 4th St Ste 208 Louisville KY 40203-3101 Ph: (502) 612-6981 | Louisville Integrated Care 1151 S 4th St Ste 208 Louisville KY 40203-3101 Ph: (502) 612-6981 |
| NPI Number | 1669093647 |
|---|---|
| Provider Enumeration Date | 05/01/2020 |
| Last Update Date | 07/09/2020 |
| Certification Date | 07/09/2020 |
| Medicare PECOS PAC ID | 1759721327 |
|---|---|
| Medicare Enrollment ID | O20240430001064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669093647 | NPI | - | NPPES |
| Provider Name | John M Farmer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285703454 PECOS PAC ID: 8325944416 Enrollment ID: I20031210000051 |
| Provider Name | Harold Kweku Bedu-addo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922620624 PECOS PAC ID: 6709282924 Enrollment ID: I20210913002743 |
| Provider Name | Morgan Coy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942445879 PECOS PAC ID: 8022550383 Enrollment ID: I20240603001694 |
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