| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 305 Estill St, Berea, Kentucky |
| Authorized Official Name and Position | Carmel Jones (VP AND CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 6063095506 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 73652 Cleveland OH 44193-0002 Ph: (859) 313-2758 | 305 Estill St Berea KY 40403-1742 Ph: (859) 986-3151 |
| NPI Number | 1144523911 |
|---|---|
| Provider Enumeration Date | 12/16/2010 |
| Last Update Date | 08/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144523911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | PA1195 (Kentucky) | Secondary |
Department Of Veterans Affairs Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 Pauline Dr, Berea, KY 40403 Phone: 859-233-4511 Fax: 859-986-1289 | |
Berea Health Ministry, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Estill Street, Berea, KY 40403 Phone: 859-986-1274 Fax: 859-986-1279 | |
Everside Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Mayde Rd, Berea, KY 40403 Phone: 859-986-2359 |