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95 Sr 3444 Hwy Annville KY 40402-0398 | |
(606) 364-5162 | |
(606) 364-3920 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 95 Sr 3444 Hwy, Annville, Kentucky |
Authorized Official Name and Position | Carla Jean Johnson (INS. BILLING CREDENTIALING CLERK) |
Authorized Official Contact | 6068436195 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2659 North Laurel Road P O Box 495 East Bernstadt KY 40729-0000 Ph: (606) 843-6195 | 95 Sr 3444 Hwy Annville KY 40402-0398 Ph: (606) 364-5162 |
NPI Number | 1336109644 |
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Provider Enumeration Date | 03/23/2006 |
Last Update Date | 10/20/2011 |
Identifier | Type | State | Issuer |
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1336109644 | NPI | - | NPPES |
7100071750 | Medicaid | KY |