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427 Us 31w Byp Bowling Green KY 42101-1703 | |
| (270) 796-8800 | |
| (270) 796-9328 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 427 Us 31w Byp, Bowling Green, Kentucky |
| Authorized Official Name and Position | Kalidas G Sahetya (SECRETARY) |
| Authorized Official Contact | 2707968800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 90039 Bowling Green KY 42102-9039 Ph: (270) 796-8800 | 427 Us 31w Byp Bowling Green KY 42101-1703 Ph: (270) 796-8800 |
| NPI Number | 1962462382 |
|---|---|
| Provider Enumeration Date | 03/28/2006 |
| Last Update Date | 10/18/2011 |
| Medicare PECOS PAC ID | 2860487816 |
|---|---|
| Medicare Enrollment ID | O20040419000613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962462382 | NPI | - | NPPES |
| 65930562 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Tori Lee Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639283963 PECOS PAC ID: 3678524675 Enrollment ID: I20050208000155 |
| Provider Name | Lorie Michelle Wardlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336111673 PECOS PAC ID: 6608897111 Enrollment ID: I20051213000260 |
| Provider Name | Catherine G Heltsley |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1386675395 PECOS PAC ID: 8325183080 Enrollment ID: I20100305000059 |
| Provider Name | Deepak N. Gaba |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1366404782 PECOS PAC ID: 2163557281 Enrollment ID: I20100315000800 |
| Provider Name | William E Harston |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932103785 PECOS PAC ID: 2466589353 Enrollment ID: I20100426000095 |
| Provider Name | Lori R Marrero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124425418 PECOS PAC ID: 5597089391 Enrollment ID: I20150127002132 |
| Provider Name | Stephen L Moore |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1992785018 PECOS PAC ID: 2163329087 Enrollment ID: I20151022002821 |
| Provider Name | Angela G Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346776390 PECOS PAC ID: 5193093953 Enrollment ID: I20170620000726 |
Verdant Healthcare Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1300 Andrea St, Suite 100, Bowling Green, KY 42104 Phone: 270-780-3546 Fax: 270-780-3547 | |
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Cumberland Family Medical Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2617 Russellville Road, Bowling Green, KY 42101 Phone: 844-435-0900 Fax: 270-858-4029 | |
Cumberland Family Medical Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1808 Loop Drive, Bowling Green, KY 42101 Phone: 844-435-0900 Fax: 270-858-4029 | |
Cumberland Family Medical Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 265 Lovers Lane, Bowling Green, KY 42103 Phone: 844-435-0900 Fax: 270-858-4029 |