| Bluegrass Med Care | |
|
4863 Scottsville Rd Ste B Bowling Green KY 42104-7949 | |
| (270) 843-5662 | |
| (270) 843-5614 |
| Full Name | Bluegrass Med Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 4863 Scottsville Rd Ste B, Bowling Green, Kentucky |
| Authorized Official Name and Position | Elizabeth Lanham (OWNER) |
| Authorized Official Contact | 2708435662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluegrass Med Care 4863 Scottsville Rd Ste B Bowling Green KY 42104-7949 Ph: (270) 843-5662 | Bluegrass Med Care 4863 Scottsville Rd Ste B Bowling Green KY 42104-7949 Ph: (270) 843-5662 |
| NPI Number | 1861118895 |
|---|---|
| Provider Enumeration Date | 10/12/2022 |
| Last Update Date | 10/12/2022 |
| Medicare PECOS PAC ID | 2961873542 |
|---|---|
| Medicare Enrollment ID | O20230118000867 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861118895 | NPI | - | NPPES |
| 7100796090 | Medicaid | KY | |
| 64250715 | Medicaid | KY | |
| 7100561960 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Rosalie Padilla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851354401 PECOS PAC ID: 6204937139 Enrollment ID: I20070723000501 |
| Provider Name | Malorie M. Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417601444 PECOS PAC ID: 3678967387 Enrollment ID: I20220223000966 |
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