| Commonwealth Of Kentucky | |
|
2400 Russellville Rd Hopkinsville KY 42240-8095 | |
| (270) 889-6025 | |
| (270) 886-4487 |
| Full Name | Commonwealth Of Kentucky |
|---|---|
| Speciality | Psychiatric Hospital |
| Location | 2400 Russellville Rd, Hopkinsville, Kentucky |
| Authorized Official Name and Position | Jennifer Moore (ASSISTANT DIRECTOR) |
| Authorized Official Contact | 5027826117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Of Kentucky 2440 Russellville Road Hopkinsville KY 42240 Ph: (270) 889-6025 | Commonwealth Of Kentucky 2400 Russellville Rd Hopkinsville KY 42240-8095 Ph: (270) 889-6025 |
| NPI Number | 1508861683 |
|---|---|
| Provider Enumeration Date | 06/16/2005 |
| Last Update Date | 08/07/2024 |
| Certification Date | 08/07/2024 |
| Medicare PECOS PAC ID | 1456255942 |
|---|---|
| Medicare Enrollment ID | O20110103000177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508861683 | NPI | - | NPPES |
| 65944852 | Medicaid | KY | |
| 02020022 | Medicaid | KY |
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