| Vip Community Health Llc | |
|
503 Humston Dr Lawrenceburg KY 40342-1927 | |
| (270) 543-7557 | |
| Not Available |
| Full Name | Vip Community Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 503 Humston Dr, Lawrenceburg, Kentucky |
| Authorized Official Name and Position | Debra Hardison (OWNER) |
| Authorized Official Contact | 2705437557 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vip Community Health Llc 3064 Pea Ridge Rd Waddy KY 40076-6107 Ph: (270) 543-7557 | Vip Community Health Llc 503 Humston Dr Lawrenceburg KY 40342-1927 Ph: (270) 543-7557 |
| NPI Number | 1568152098 |
|---|---|
| Provider Enumeration Date | 05/09/2023 |
| Last Update Date | 01/29/2025 |
| Certification Date | 01/29/2025 |
| Medicare PECOS PAC ID | 7618339326 |
|---|---|
| Medicare Enrollment ID | O20230811003031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568152098 | NPI | - | NPPES |
| Provider Name | Barry G Hardison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225039258 PECOS PAC ID: 4880697713 Enrollment ID: I20081108000052 |
| Provider Name | Joyce Marie Lovell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497356745 PECOS PAC ID: 3173934601 Enrollment ID: I20201204000552 |
| Provider Name | Debra L Hardison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851922744 PECOS PAC ID: 8426460239 Enrollment ID: I20201221001543 |
| Provider Name | Joey Kyle Creekbaum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639802515 PECOS PAC ID: 1456733922 Enrollment ID: I20220729002299 |
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