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44 W Main St Fordsville KY 42343-9761 | |
(270) 276-9953 | |
(270) 276-9958 |
Full Name | |
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Speciality | Clinic/Center |
Location | 44 W Main St, Fordsville, Kentucky |
Authorized Official Name and Position | Jennifer Daugherty (PFS DIRECTOR) |
Authorized Official Contact | 2705041910 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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44 W Main St Fordsville KY 42343-9761 Ph: (270) 276-9953 | 44 W Main St Fordsville KY 42343-9761 Ph: (270) 276-9953 |
NPI Number | 1750447231 |
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Provider Enumeration Date | 12/28/2006 |
Last Update Date | 03/19/2024 |
Medicare PECOS PAC ID | 3577477264 |
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Medicare Enrollment ID | O20120406000447 |
Identifier | Type | State | Issuer |
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1750447231 | NPI | - | NPPES |
35000454 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 900048 (Kentucky) | Primary |