Clover Fork Outpatient Medical Project Inc | |
101 Chad St Clover Fork Clinic Evarts KY 40828-8200 | |
(606) 837-2108 | |
(606) 837-9389 |
Full Name | Clover Fork Outpatient Medical Project Inc |
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Speciality | Clinic/Center |
Location | 101 Chad St, Evarts, Kentucky |
Authorized Official Name and Position | Britt Lewis (ADMINISTRATOR) |
Authorized Official Contact | 6068372108 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Clover Fork Outpatient Medical Project Inc 101 Chad St Po Box39 Evarts KY 40828-8200 Ph: (606) 837-2108 | Clover Fork Outpatient Medical Project Inc 101 Chad St Clover Fork Clinic Evarts KY 40828-8200 Ph: (606) 837-2108 |
NPI Number | 1811939366 |
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Provider Enumeration Date | 06/11/2006 |
Last Update Date | 11/19/2018 |
Medicare PECOS PAC ID | 2062317027 |
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Medicare Enrollment ID | O20040126000246 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811939366 | NPI | - | NPPES |
31000045 | Medicaid | KY | |
7100323670 | Medicaid | KY |
Provider Name | Sharon Marie Colton |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245264852 PECOS PAC ID: 6204739121 Enrollment ID: I20040129000031 |
Provider Name | Rachel R Eubank |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1700810314 PECOS PAC ID: 5092618918 Enrollment ID: I20040129000051 |
Provider Name | Anya K Cope |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1972815678 PECOS PAC ID: 7911140785 Enrollment ID: I20150330000878 |
Provider Name | Kristen M Nash |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609308618 PECOS PAC ID: 0840561205 Enrollment ID: I20200914000531 |
Provider Name | Jessica Turner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639776990 PECOS PAC ID: 2062810534 Enrollment ID: I20211013003529 |