| Casey County Primary Care | |
|
187 Wolford Ave Liberty KY 42539-3187 | |
| (606) 787-6275 | |
| (606) 787-8925 |
| Full Name | Casey County Primary Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 187 Wolford Ave, Liberty, Kentucky |
| Authorized Official Name and Position | Rex A. Tungate (CEO ADMINSTRATOR) |
| Authorized Official Contact | 2704030732 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Casey County Primary Care 187 Wolford Ave Liberty KY 42539-3187 Ph: (606) 787-6275 | Casey County Primary Care 187 Wolford Ave Liberty KY 42539-3187 Ph: (606) 787-6275 |
| NPI Number | 1871567362 |
|---|---|
| Provider Enumeration Date | 02/14/2006 |
| Last Update Date | 02/23/2017 |
| Medicare PECOS PAC ID | 0749193423 |
|---|---|
| Medicare Enrollment ID | O20071207000184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871567362 | NPI | - | NPPES |
| 65909897 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 900075 (Kentucky) | Primary |
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