| White House Clinics | |
|
103 Southern Soul Way Lancaster KY 40444 | |
| (859) 942-7787 | |
| Not Available |
| Full Name | White House Clinics |
|---|---|
| Speciality | Clinic/Center |
| Location | 103 Southern Soul Way, Lancaster, 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 Clinics 401 Highland Park Dr Richmond KY 40475-3839 Ph: (859) 626-7700 | White House Clinics 103 Southern Soul Way Lancaster KY 40444 Ph: (859) 942-7787 |
| NPI Number | 1588187504 |
|---|---|
| Provider Enumeration Date | 07/21/2017 |
| Last Update Date | 06/14/2022 |
| Medicare PECOS PAC ID | 8224946561 |
|---|---|
| Medicare Enrollment ID | O20180404002896 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588187504 | NPI | - | NPPES |
| 31000243 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 700030 (Kentucky) | Primary |
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