| Pennyroyal Center | |
|
735 North Dr Hopkinsville KY 42240-2620 | |
| (270) 886-5163 | |
| Not Available |
| Full Name | Pennyroyal Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 735 North Dr, Hopkinsville, Kentucky |
| Authorized Official Name and Position | Tommi Michelle Holloway (VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 2709015000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pennyroyal Center Po Box 614 Hopkinsville KY 42241-0614 Ph: (270) 886-2205 | Pennyroyal Center 735 North Dr Hopkinsville KY 42240-2620 Ph: (270) 886-5163 |
| NPI Number | 1356995781 |
|---|---|
| Provider Enumeration Date | 07/24/2019 |
| Last Update Date | 02/05/2021 |
| Certification Date | 02/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356995781 | NPI | - | NPPES |
| 7100037630 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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