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2625 Scottsville Rd Bowling Green KY 42104-4477 | |
| (270) 745-1010 | |
| (270) 745-0683 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 2625 Scottsville Rd, Bowling Green, Kentucky |
| Authorized Official Name and Position | Connie Smith (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 2707451268 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 90010 Bowling Green KY 42102-9010 Ph: (270) 745-1467 | 2625 Scottsville Rd Bowling Green KY 42104-4477 Ph: (270) 745-1010 |
| NPI Number | 1336170802 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336170802 | NPI | - | NPPES |
| 65904146 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (Kentucky) | Primary |
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