| Glk Enterprises, Llc | |
|
104 Mohawk Street Brownsville KY 42210 | |
| (270) 597-2155 | |
| (270) 597-3811 |
| Full Name | Glk Enterprises, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 104 Mohawk Street, Brownsville, Kentucky |
| Authorized Official Name and Position | Sanjay Kaul (MD/PRESIDENT) |
| Authorized Official Contact | 2705972155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glk Enterprises, Llc 104 Mohawk Street Brownsville KY 42210 Ph: (270) 597-2155 | Glk Enterprises, Llc 104 Mohawk Street Brownsville KY 42210 Ph: (270) 597-2155 |
| NPI Number | 1912912734 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5092711655 |
|---|---|
| Medicare Enrollment ID | O20061005000083 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912912734 | NPI | - | NPPES |
| 64030224 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 36833 (Kentucky) | Primary |
| Provider Name | Sanjay Kaul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992777866 PECOS PAC ID: 2062301526 Enrollment ID: I20040312000472 |
| Provider Name | Sherry R Rudnick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720266851 PECOS PAC ID: 5395820542 Enrollment ID: I20080312000050 |
| Provider Name | Jasmaine D Theobald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346624962 PECOS PAC ID: 7810291002 Enrollment ID: I20160209001014 |
| Provider Name | Blair R Mendoza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710332648 PECOS PAC ID: 0345532396 Enrollment ID: I20160712001036 |
| Provider Name | Courtney N Fazel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548732092 PECOS PAC ID: 6507105657 Enrollment ID: I20190307000174 |
| Provider Name | Lauren M Casey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891461190 PECOS PAC ID: 8527455625 Enrollment ID: I20220419002805 |
Edmonson County High School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 220 Wildcat Way, Brownsville, KY 42210 Phone: 270-975-4050 | |
A Plus Family Healthcare Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 210 S Main St Ste 101, Brownsville, KY 42210 Phone: 270-975-4050 Fax: 270-975-4002 | |
Edmonson County 5/6 Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 191 W Center St, Brownsville, KY 42210 Phone: 270-975-4050 | |
A Plus Family Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 Wild Cat Way, Brownsville, KY 42210 Phone: 270-975-4050 | |
Associates In Physician Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1573 Hwy 259n, Brownsville, KY 42210 Phone: 270-597-2168 Fax: 270-597-2033 |