| Sunrise Glen Dale Center Healthy Kids Clinic | |
|
1030 Commerce Drive Elizabethtown KY 42701-1281 | |
| (502) 538-1000 | |
| (270) 858-4029 |
| Full Name | Sunrise Glen Dale Center Healthy Kids Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1030 Commerce Drive, Elizabethtown, Kentucky |
| Authorized Official Name and Position | Eric E Loy (CEO) |
| Authorized Official Contact | 2708586655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Glen Dale Center Healthy Kids Clinic Po Box 1080 Burkesville KY 42717-1080 Ph: (270) 858-6655 | Sunrise Glen Dale Center Healthy Kids Clinic 1030 Commerce Drive Elizabethtown KY 42701-1281 Ph: (502) 538-1000 |
| NPI Number | 1720799224 |
|---|---|
| Provider Enumeration Date | 12/06/2022 |
| Last Update Date | 06/03/2023 |
| Medicare PECOS PAC ID | 6305947789 |
|---|---|
| Medicare Enrollment ID | O20230407001382 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720799224 | NPI | - | NPPES |
| 7100017280 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Primary Care @ Home, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1105 Julianna Ct, Suite 1, Elizabethtown, KY 42701 Phone: 270-763-0030 Fax: 270-763-0050 | |
Raza Malik, Md, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1528 Yorkshire Dr, Elizabethtown, KY 42701 Phone: 270-360-9170 | |
Primecare Psc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2413 Ring Rd Ste 110, Elizabethtown, KY 42701 Phone: 270-765-4535 Fax: 270-763-1901 | |
Heartland Patient Care, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 914 N Dixie Ave, Suite 302, Elizabethtown, KY 42701 Phone: 270-769-0892 Fax: 270-769-1857 | |
Zipclinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2005 N Dixie Ave, Elizabethtown, KY 42701 Phone: 270-640-0146 Fax: 270-640-0889 | |
Paul Gerard Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Helmwood Plaza Dr, Elizabethtown, KY 42701 Phone: 270-769-5579 Fax: 270-765-7975 | |
Elizabethtown Family Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1239 Woodland Dr, Ste 106, Elizabethtown, KY 42701 Phone: 270-360-0851 Fax: 270-360-0859 |