| White House Clinic-richmond | |
|
401 Highland Park Dr Richmond KY 40475 | |
| (859) 626-7700 | |
| (859) 626-7890 |
| Full Name | White House Clinic-richmond |
|---|---|
| Speciality | Clinic/Center |
| Location | 401 Highland Park Dr, Richmond, 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-richmond 1010 Main St S Mc Kee KY 40447-7089 Ph: (606) 287-7104 | White House Clinic-richmond 401 Highland Park Dr Richmond KY 40475 Ph: (859) 626-7700 |
| NPI Number | 1659358398 |
|---|---|
| Provider Enumeration Date | 12/23/2005 |
| Last Update Date | 07/17/2018 |
| Medicare PECOS PAC ID | 8224946561 |
|---|---|
| Medicare Enrollment ID | O20051228000630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659358398 | NPI | - | NPPES |
| 31000243 | Medicaid | KY | |
| 9220 | Other | KY | MEDICARE ADMINISTAR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 700030 (Kentucky) | Primary |
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