COMMUNTIY HEALTHCARE OF WESTERN KENTUCKY LLC (NPI# 1780102301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780102301 |
Entity Type | Organization |
Organization Name | COMMUNTIY HEALTHCARE OF WESTERN KENTUCKY LLC |
Practice Address |
308 South Washington Street Suite 200 Clinton KY 42031 |
Mailing Address |
308 South Washington Street Suite 200 Clinton KY 42031-1347 |
Practice Telephone | (270) 653-0220 |
Practice Fax Number | 2706530221 |
Mailing Telephone | 2706530220 |
Mailing Fax Number | 2706530221 |
Enumeration Date | 2017-09-04 |
Last Update Date | 2017-10-20 |
Authorized Official Name | MRS. STEPHANNIE LORENE GOODRUM (OWNER) |
Authorized Official Telephone | 2706530220 |
Authorized Official Credential | RN |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KY | NPI | 1760722144 | 01 |
KY | 7100237310 | 05 |
Street Address |
308 SOUTH WASHINGTON STREET SUITE 200 |
City | CLINTON |
State | KY |
Zip Code | 42031 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053569442 | Hickman County High School Clinic | Public Health or Welfare | 301 East Cresap Street, Clinton, KY 42031 | 2008-08-28 |
1437186657 | Purchase District Health Dept | Public Health or Welfare | 370 S Washington Street, Clinton, KY 42031 | 2006-06-26 |
1104800101 | Arbor Place of Clinton | Skilled Nursing Facility | 106 Padgett Drive, Clinton, KY 42031 | 2005-12-02 |
1902954118 | Clinton-hickman County Ambulance Service Inc | Ambulance | 324 James H Phillips Dr, Clinton, KY 42031-0083 | 2007-01-07 |
1568902427 | Clinton Pharmacy LLC | Pharmacy | 119 E Clay St, Clinton, KY 42031-1222 | 2017-02-26 |
1932131356 | Byassee Drug Company Inc | Durable Medical Equipment & Medical Supplies | 107 E Clay St, Clinton, KY 42031-1222 | 2006-07-07 |
1174087647 | Clinton Pharmacy LLC | Pharmacy | 119 E Clay St, Clinton, KY 42031-1222 | 2019-01-29 |
1205048873 | John Garland Byassee | Pharmacist | 107 E Clay St, Clinton, KY 42031-1222 | 2007-05-04 |
1275617755 | Perkins Pharmacy | Durable Medical Equipment & Medical Supplies | 119 E Clay St, Clinton, KY 42031-1222 | 2006-10-24 |
1982747804 | Purchase District Health Dept | Public Health or Welfare | 416 Mcmorris St, Clinton, KY 42031-1244 | 2007-02-14 |
Find all providers in zip 42031 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
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1396390498 | Team Clinic Management Partners LLC | Clinic/Center | 1903 Opal Ave, Clinton, OK 73601-5139 | 2019-08-06 |
1982257812 | Team Clinic Management Partners LLC | Clinic/Center | 1001 Orient Ave, Clinton, OK 73601-2751 | 2019-07-19 |
1023414828 | Still I Rise, Inc | Clinic/Center | 9023 Woodyard Rd, Clinton, MD 20735-4208 | 2014-11-06 |
1417146952 | Clinton Family Practice, Inc. | Clinic/Center | 201 Jacobs Hwy, Clinton, SC 29325-7278 | 2007-10-22 |
1013108240 | Family Practice Center | Clinic/Center | 194 Shakerag Road, Clinton, AR 72031 | 2007-08-05 |
1184674392 | Westview Health Clinic, Plc | Clinic/Center | 3140 Hayes Ave, Clinton, OK 73601-3601 | 2006-05-10 |
1841845948 | Team Clinic Management Partners LLC | Clinic/Center | 300 S 11th St, Clinton, OK 73601-3933 | 2019-08-06 |
1891348736 | Team Clinic Management Partners LLC | Clinic/Center | 2130 W Gary Blvd, Clinton, OK 73601-5304 | 2019-07-19 |
1407409642 | Team Clinic Management Partners | Clinic/Center | 601 N 13th St, Clinton, OK 73601-1831 | 2019-07-17 |
1295285906 | White County Medical Center | Clinic/Center | 175 Volunteer Pkwy, Clinton, AR 72031-8001 | 2016-10-05 |
Find all providers in CLINTON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.