| Blue Crescent-blue Star Medical Of Kentucky, Inc | |
|
95 S Main St Dry Ridge KY 41035-7343 | |
| (859) 823-0000 | |
| Not Available |
| Full Name | Blue Crescent-blue Star Medical Of Kentucky, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 95 S Main St, Dry Ridge, Kentucky |
| Authorized Official Name and Position | Sundiata M El-amin (OWNER) |
| Authorized Official Contact | 8598230000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Crescent-blue Star Medical Of Kentucky, Inc 95 S Main St Dry Ridge KY 41035-7343 Ph: (859) 823-0000 | Blue Crescent-blue Star Medical Of Kentucky, Inc 95 S Main St Dry Ridge KY 41035-7343 Ph: (859) 823-0000 |
| NPI Number | 1396044301 |
|---|---|
| Provider Enumeration Date | 03/17/2011 |
| Last Update Date | 03/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396044301 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 21770KY (Kentucky) | Primary |
Fast Pace Kentucky Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 38 Broadway Street, Dry Ridge, KY 41035 Phone: 859-300-0694 |