| Southside Elementary Healthy Kids Clinic | |
|
1300 Troy Pike Versailles KY 40383-9642 | |
| (859) 879-4660 | |
| (270) 858-4029 |
| Full Name | Southside Elementary Healthy Kids Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1300 Troy Pike, Versailles, Kentucky |
| Authorized Official Name and Position | Eric E Loy (CEO) |
| Authorized Official Contact | 2708586655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Elementary Healthy Kids Clinic Po Box 1080 Burkesville KY 42717-1080 Ph: (270) 858-6655 | Southside Elementary Healthy Kids Clinic 1300 Troy Pike Versailles KY 40383-9642 Ph: (859) 879-4660 |
| NPI Number | 1083390330 |
|---|---|
| Provider Enumeration Date | 06/22/2023 |
| Last Update Date | 06/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083390330 | NPI | - | NPPES |
| 7100017280 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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