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75 Tick Ridge Rd Waynesburg KY 40489-8202 | |
| (844) 435-0900 | |
| (270) 858-4029 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 75 Tick Ridge Rd, Waynesburg, Kentucky |
| Authorized Official Name and Position | Eric E Loy (CEO) |
| Authorized Official Contact | 2408641472 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1080 Burkesville KY 42717-1080 Ph: (270) 858-6644 | 75 Tick Ridge Rd Waynesburg KY 40489-8202 Ph: (844) 435-0900 |
| NPI Number | 1063943736 |
|---|---|
| Provider Enumeration Date | 03/24/2017 |
| Last Update Date | 03/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063943736 | NPI | - | NPPES |
| 700172 | Other | KY | STATE LICENSE |
| 7100017280 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 700172 (Kentucky) | Primary |
Faith Healthcare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14098 Us Highway 27 S, Waynesburg, KY 40489 Phone: 606-379-6646 | |
Waynesburg Clinic, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14098 Us Highway 27 S, Waynesburg, KY 40489 Phone: 606-379-6646 Fax: 606-379-5707 |