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305 Estill St 4th Floor Berea KY 40403-1742 | |
| (859) 986-2343 | |
| (859) 986-2344 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 305 Estill St, Berea, Kentucky |
| Authorized Official Name and Position | Kandi R Rea (PHYSICIAN CREDENTIALING) |
| Authorized Official Contact | 6063303404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 73652 Cleveland OH 44193-0002 Ph: (606) 330-3404 | 305 Estill St 4th Floor Berea KY 40403-1742 Ph: (859) 986-2343 |
| NPI Number | 1912144791 |
|---|---|
| Provider Enumeration Date | 01/15/2009 |
| Last Update Date | 01/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912144791 | NPI | - | NPPES |
| 7100002060 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Department Of Veterans Affairs Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 Pauline Dr, Berea, KY 40403 Phone: 859-233-4511 Fax: 859-986-1289 | |
Berea Health Ministry, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Estill Street, Berea, KY 40403 Phone: 859-986-1274 Fax: 859-986-1279 | |
Everside Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Mayde Rd, Berea, KY 40403 Phone: 859-986-2359 |