| Clark Medical Ventures, Llc | |
|
174 Pedro Way Winchester KY 40391-8354 | |
| (859) 355-5653 | |
| Not Available |
| Full Name | Clark Medical Ventures, Llc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 174 Pedro Way, Winchester, Kentucky |
| Authorized Official Name and Position | Brittany Underwood (CREDENTIALING AGENT) |
| Authorized Official Contact | 8593038746 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Medical Ventures, Llc 1031 Wellington Way Ste 240 Lexington KY 40513-1257 Ph: (859) 303-8746 | Clark Medical Ventures, Llc 174 Pedro Way Winchester KY 40391-8354 Ph: (859) 355-5653 |
| NPI Number | 1043650591 |
|---|---|
| Provider Enumeration Date | 06/28/2013 |
| Last Update Date | 09/02/2021 |
| Certification Date | 09/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043650591 | NPI | - | NPPES |
| 7100303720 | Medicaid | KY |
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