| Homeplace Clinic Louisa | |
|
118 Blairs Way Louisa KY 41230-6389 | |
| (606) 638-9522 | |
| (606) 638-3548 |
| Full Name | Homeplace Clinic Louisa |
|---|---|
| Speciality | Clinic/Center |
| Location | 118 Blairs Way, Louisa, Kentucky |
| Authorized Official Name and Position | Roxann Cordial (CREDENTIALING) |
| Authorized Official Contact | 6068868572 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Homeplace Clinic Louisa 104 S Front Ave Prestonsburg KY 41653-1614 Ph: (606) 886-8572 | Homeplace Clinic Louisa 118 Blairs Way Louisa KY 41230-6389 Ph: (606) 638-9522 |
| NPI Number | 1114426863 |
|---|---|
| Provider Enumeration Date | 02/08/2018 |
| Last Update Date | 08/15/2024 |
| Medicare PECOS PAC ID | 5294720553 |
|---|---|
| Medicare Enrollment ID | O20180828003612 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114426863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 700264 (Kentucky) | Primary |
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