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648 University Shopping Ctr Richmond KY 40475-2614 | |
(859) 623-1950 | |
(859) 623-0619 |
Full Name | |
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Speciality | Clinic/Center |
Location | 648 University Shopping Ctr, Richmond, Kentucky |
Authorized Official Name and Position | Danyel D Clay (VP REVENUE CYCLE) |
Authorized Official Contact | 5022534911 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1901 Campus Pl Louisville KY 40299-2308 Ph: (502) 259-4911 | 648 University Shopping Ctr Richmond KY 40475-2614 Ph: (859) 623-1950 |
NPI Number | 1831744176 |
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Provider Enumeration Date | 08/05/2019 |
Last Update Date | 07/22/2024 |
Medicare PECOS PAC ID | 5597867184 |
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Medicare Enrollment ID | O20191024002220 |
Identifier | Type | State | Issuer |
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1831744176 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Kimberly Spencer |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316323850 PECOS PAC ID: 5193032506 Enrollment ID: I20150917001581 |
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