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360 Keen Street Burkesville KY 42717 | |
(270) 864-2889 | |
(270) 864-2229 |
Full Name | |
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Speciality | Clinic/Center |
Location | 360 Keen Street, Burkesville, Kentucky |
Authorized Official Name and Position | Eric E Loy (CEO) |
Authorized Official Contact | 2708641472 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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P.o. Box 1080 Burkesville KY 42717-1080 Ph: (270) 864-1472 | 360 Keen Street Burkesville KY 42717 Ph: (270) 864-2889 |
NPI Number | 1306873500 |
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Provider Enumeration Date | 06/26/2006 |
Last Update Date | 05/01/2014 |
Medicare PECOS PAC ID | 6305947789 |
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Medicare Enrollment ID | O20070730000394 |
Identifier | Type | State | Issuer |
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1306873500 | NPI | - | NPPES |
7100017280 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 700172 (Kentucky) | Primary |
Provider Name | Lora L Meadows-keltner |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1417987157 PECOS PAC ID: 0648615799 Enrollment ID: I20240228001740 |
Loy Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 340 Keen St, Burkesville, KY 42717 Phone: 270-864-2889 Fax: 270-864-2229 |