St. Michael's Health Clinic | |
2801 Walter Garrett Ln Oak Grove KY 42262-9998 | |
(270) 640-5821 | |
(844) 270-5587 |
Full Name | St. Michael's Health Clinic |
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Speciality | Clinic/Center |
Location | 2801 Walter Garrett Ln, Oak Grove, Kentucky |
Authorized Official Name and Position | Kimberly Riddle (DNP, APRN) |
Authorized Official Contact | 2706405821 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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St. Michael's Health Clinic 2801 Walter Garrett Ln. Oak Grove KY 42262-9998 Ph: (270) 640-5821 | St. Michael's Health Clinic 2801 Walter Garrett Ln Oak Grove KY 42262-9998 Ph: (270) 640-5821 |
NPI Number | 1366800922 |
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Provider Enumeration Date | 02/10/2016 |
Last Update Date | 03/30/2016 |
Medicare PECOS PAC ID | 0244529980 |
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Medicare Enrollment ID | O20160518002499 |
Identifier | Type | State | Issuer |
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1366800922 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 3004526 (Kentucky) | Primary |
Provider Name | Kimberly J Cecil-riddle |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215171251 PECOS PAC ID: 7315096641 Enrollment ID: I20160518002704 |
Pennyroyal Healthcare Services, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 244 Thompsonville Ln, Oak Grove, KY 42262 Phone: 270-365-2227 Fax: 270-365-2559 |