| White House Clinic | |
|
104 Legacy Dr Berea KY 40403 | |
| (859) 986-2323 | |
| (859) 986-7728 |
| Full Name | White House Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 104 Legacy Dr, Berea, Kentucky |
| Authorized Official Name and Position | Jenny Sargent (CREDENTIALER) |
| Authorized Official Contact | 8596267700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| White House Clinic 1010 Main St S Mc Kee KY 40447-7089 Ph: (606) 287-7104 | White House Clinic 104 Legacy Dr Berea KY 40403 Ph: (859) 986-2323 |
| NPI Number | 1023094695 |
|---|---|
| Provider Enumeration Date | 12/15/2005 |
| Last Update Date | 07/17/2018 |
| Medicare PECOS PAC ID | 8224946561 |
|---|---|
| Medicare Enrollment ID | O20050307000079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023094695 | NPI | - | NPPES |
| 0681 | Other | KY | MEDICARE ADMINISTAR |
| 31000243 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 700030 (Kentucky) | Primary |
Berea Hospitalists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 305 Estill St, Berea, KY 40403 Phone: 859-986-3151 | |
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 | |
Faith Dental Of Berea Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 206 Richmond Rd N, Berea, KY 40403 Phone: 859-986-8491 | |
Berea Walk-in Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 245 Prince Royal Dr, Suite A, Berea, KY 40403 Phone: 859-582-7663 Fax: 859-335-1560 | |
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 |