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4359 Shepherdsville Road Ste 255 Bardstown KY 40004 | |
(502) 350-5800 | |
(502) 350-5820 |
Full Name | |
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Speciality | Clinic/Center |
Location | 4359 Shepherdsville Road, Bardstown, Kentucky |
Authorized Official Name and Position | Christy Lynn Spitser (MARKET VICE PRESIDENT) |
Authorized Official Contact | 6063306016 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 936 London KY 40743-0936 Ph: (606) 330-7835 | 4359 Shepherdsville Road Ste 255 Bardstown KY 40004 Ph: (502) 350-5800 |
NPI Number | 1710590880 |
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Provider Enumeration Date | 08/28/2020 |
Last Update Date | 01/25/2023 |
Medicare PECOS PAC ID | 5890692024 |
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Medicare Enrollment ID | O20201012000459 |
Identifier | Type | State | Issuer |
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1710590880 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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