| Breckinridge Health, Inc. | |
|
209 Elm St Cloverport KY 40111-1324 | |
| (270) 788-3000 | |
| (270) 788-6201 |
| Full Name | Breckinridge Health, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 209 Elm St, Cloverport, Kentucky |
| Authorized Official Name and Position | Mandy J Butler (NURSE PRACTITIONER) |
| Authorized Official Contact | 2707883000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Breckinridge Health, Inc. 209 Elm St Cloverport KY 40111-1324 Ph: (270) 788-3000 | Breckinridge Health, Inc. 209 Elm St Cloverport KY 40111-1324 Ph: (270) 788-3000 |
| NPI Number | 1245236900 |
|---|---|
| Provider Enumeration Date | 06/27/2005 |
| Last Update Date | 03/29/2017 |
| Medicare PECOS PAC ID | 0941106454 |
|---|---|
| Medicare Enrollment ID | O20100507000344 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245236900 | NPI | - | NPPES |
| 35000587 | Medicaid | KY | |
| 1049478 | Other | KY | PASSPORT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 900053 (Kentucky) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | 900053 (Kentucky) | Primary |