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2494 Church Street Oakland KY 42159-6809 | |
(844) 435-0900 | |
(270) 858-4029 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2494 Church Street, Oakland, Kentucky |
Authorized Official Name and Position | Eric E Loy (CEO) |
Authorized Official Contact | 2708586655 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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P.o. Box 1080 Burkesville KY 42717-1080 Ph: (270) 858-6655 | 2494 Church Street Oakland KY 42159-6809 Ph: (844) 435-0900 |
NPI Number | 1932826989 |
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Provider Enumeration Date | 10/20/2022 |
Last Update Date | 10/21/2022 |
Medicare PECOS PAC ID | 6305947789 |
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Medicare Enrollment ID | O20230424001850 |
Identifier | Type | State | Issuer |
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1932826989 | NPI | - | NPPES |
7100017280 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |