| Park Duvalle At Central Health Center | |
|
1130 W Chestnut St Louisville KY 40203-2047 | |
| (502) 772-4401 | |
| Not Available |
| Full Name | Park Duvalle At Central Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1130 W Chestnut St, Louisville, Kentucky |
| Authorized Official Name and Position | Swannie Jett (CEO) |
| Authorized Official Contact | 5027744401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Duvalle At Central Health Center 3015 Wilson Ave Louisville KY 40211-1969 Ph: (502) 774-4401 | Park Duvalle At Central Health Center 1130 W Chestnut St Louisville KY 40203-2047 Ph: (502) 772-4401 |
| NPI Number | 1639727951 |
|---|---|
| Provider Enumeration Date | 08/29/2019 |
| Last Update Date | 11/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639727951 | NPI | - | NPPES |
| 31000011 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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