| Family Health Center Southwest | |
|
9702 Stonestreet Road Medical Office Building 1, Suite 220 Louisville KY 40272-2847 | |
| (502) 995-5051 | |
| (502) 995-5078 |
| Full Name | Family Health Center Southwest |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 9702 Stonestreet Road, Louisville, Kentucky |
| Authorized Official Name and Position | Bart Irwin (CEO (INTERIM)) |
| Authorized Official Contact | 5027748631 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Center Southwest Po Box 950244 Louisville KY 40295-0244 Ph: (502) 953-4700 | Family Health Center Southwest 9702 Stonestreet Road Medical Office Building 1, Suite 220 Louisville KY 40272-2847 Ph: (502) 995-5051 |
| NPI Number | 1104879469 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 07/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104879469 | NPI | - | NPPES |
| 31000052 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 700013 (Kentucky) | Primary |
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