Cloverport Health Clinic | |
209 Elm St Cloverport KY 40111-1324 | |
(270) 788-3000 | |
(270) 788-6201 |
Full Name | Cloverport Health Clinic |
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Speciality | Clinic/Center |
Location | 209 Elm St, Cloverport, Kentucky |
Authorized Official Name and Position | Mandy J Butler (NURSE PRACTITIONER) |
Authorized Official Contact | 2707883000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Cloverport Health Clinic 209 Elm St Cloverport KY 40111-1324 Ph: (270) 788-3000 | Cloverport Health Clinic 209 Elm St Cloverport KY 40111-1324 Ph: (270) 788-3000 |
NPI Number | 1245236900 |
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Provider Enumeration Date | 06/27/2005 |
Last Update Date | 03/29/2017 |
Medicare PECOS PAC ID | 0941106454 |
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Medicare Enrollment ID | O20100507000344 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245236900 | NPI | - | NPPES |
35000587 | Medicaid | KY | |
1049478 | Other | KY | PASSPORT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 900053 (Kentucky) | Secondary |
261QR1300X | Clinic/center - Rural Health | 900053 (Kentucky) | Primary |