| Commonwealth Correctional Care | |
|
15402 Champion Lakes Pl Louisville KY 40245-5601 | |
| (502) 552-3879 | |
| Not Available |
| Full Name | Commonwealth Correctional Care |
|---|---|
| Speciality | Family Medicine |
| Location | 15402 Champion Lakes Pl, Louisville, Kentucky |
| Authorized Official Name and Position | Benjamin Hale (PRESIDENT) |
| Authorized Official Contact | 6065242880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Correctional Care 15402 Champion Lakes Pl Louisville KY 40245-5601 Ph: (502) 552-3879 | Commonwealth Correctional Care 15402 Champion Lakes Pl Louisville KY 40245-5601 Ph: (502) 552-3879 |
| NPI Number | 1649060997 |
|---|---|
| Provider Enumeration Date | 05/09/2025 |
| Last Update Date | 05/09/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649060997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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