| Real Health Primary Care Llc | |
|
975 Hustonville Rd Ste 9 Danville KY 40422-2165 | |
| (859) 239-9598 | |
| (859) 239-9594 |
| Full Name | Real Health Primary Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 975 Hustonville Rd Ste 9, Danville, Kentucky |
| Authorized Official Name and Position | Joseph Cox (PRESIDENT) |
| Authorized Official Contact | 8592399598 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Real Health Primary Care Llc 975 Hustonville Rd Ste 9 Danville KY 40422-2165 Ph: (859) 239-9598 | Real Health Primary Care Llc 975 Hustonville Rd Ste 9 Danville KY 40422-2165 Ph: (859) 239-9598 |
| NPI Number | 1023691813 |
|---|---|
| Provider Enumeration Date | 04/30/2021 |
| Last Update Date | 06/11/2021 |
| Medicare PECOS PAC ID | 9537561659 |
|---|---|
| Medicare Enrollment ID | O20210713000946 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023691813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Ralph A Alvarado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881640621 PECOS PAC ID: 1153216684 Enrollment ID: I20050425000529 |
| Provider Name | Diane O Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821326760 PECOS PAC ID: 1850432782 Enrollment ID: I20100114000016 |
| Provider Name | Theresa A Wilp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376803676 PECOS PAC ID: 8729242839 Enrollment ID: I20120620000584 |
| Provider Name | Tim Gooch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740635010 PECOS PAC ID: 8729367438 Enrollment ID: I20161122000109 |
| Provider Name | Megan J. Dehart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427712264 PECOS PAC ID: 8820488802 Enrollment ID: I20211206002383 |
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