Hiseville Elementary Healthy Kids Clinic | |
149 Cardinal Drive Hiseville KY 42152-9999 | |
(270) 453-2611 | |
(270) 858-4029 |
Full Name | Hiseville Elementary Healthy Kids Clinic |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 149 Cardinal Drive, Hiseville, Kentucky |
Authorized Official Name and Position | Eric E Loy (CEO) |
Authorized Official Contact | 2708586655 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Hiseville Elementary Healthy Kids Clinic Po Box 1080 Burkesville KY 42717-1080 Ph: (270) 858-6655 | Hiseville Elementary Healthy Kids Clinic 149 Cardinal Drive Hiseville KY 42152-9999 Ph: (270) 453-2611 |
NPI Number | 1235774233 |
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Provider Enumeration Date | 11/13/2019 |
Last Update Date | 12/02/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235774233 | NPI | - | NPPES |
7100017280 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |