D/b/a Casey Family Medical | |
428 Hustonville Street Liberty KY 42539-3140 | |
(606) 787-0180 | |
(606) 787-0104 |
Full Name | D/b/a Casey Family Medical |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 428 Hustonville Street, Liberty, Kentucky |
Authorized Official Name and Position | Eric E Loy (CEO) |
Authorized Official Contact | 2708586655 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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D/b/a Casey Family Medical Po Box 2399 Russell Springs KY 42642-2399 Ph: (270) 858-6655 | D/b/a Casey Family Medical 428 Hustonville Street Liberty KY 42539-3140 Ph: (606) 787-0180 |
NPI Number | 1902228075 |
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Provider Enumeration Date | 01/09/2014 |
Last Update Date | 03/28/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902228075 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Kentucky) | Primary |
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