| Kentuckycare | |
|
75 E Court St Bardwell KY 42023-8483 | |
| (270) 628-9999 | |
| (270) 628-3334 |
| Full Name | Kentuckycare |
|---|---|
| Speciality | Clinic/Center |
| Location | 75 E Court St, Bardwell, Kentucky |
| Authorized Official Name and Position | Steven F Collier (CEO) |
| Authorized Official Contact | 8703472534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentuckycare Po Box 497 Augusta AR 72006-0497 Ph: (870) 347-2534 | Kentuckycare 75 E Court St Bardwell KY 42023-8483 Ph: (270) 628-9999 |
| NPI Number | 1669765038 |
|---|---|
| Provider Enumeration Date | 05/18/2011 |
| Last Update Date | 06/09/2022 |
| Medicare PECOS PAC ID | 2567370620 |
|---|---|
| Medicare Enrollment ID | O20110902000609 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669765038 | NPI | - | NPPES |
| 7100198250 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | 900245 (Kentucky) | Secondary |
Bardwell Wellness Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 178 Us Highway 51 N Ste B, Bardwell, KY 42023 Phone: 270-628-5445 Fax: 270-628-3179 |