| Fresh Start Health Centers Grayson | |
|
207 N Carol Malone Blvd Ste 3 Grayson KY 41143-1566 | |
| (606) 225-8200 | |
| Not Available |
| Full Name | Fresh Start Health Centers Grayson |
|---|---|
| Speciality | Clinic/Center |
| Location | 207 N Carol Malone Blvd Ste 3, Grayson, Kentucky |
| Authorized Official Name and Position | Jerrel H Boyer (CEO/OWNER) |
| Authorized Official Contact | 6069222895 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Start Health Centers Grayson 207 N Carol Malone Blvd Ste 3 Grayson KY 41143-1566 Ph: (606) 225-8200 | Fresh Start Health Centers Grayson 207 N Carol Malone Blvd Ste 3 Grayson KY 41143-1566 Ph: (606) 225-8200 |
| NPI Number | 1477206886 |
|---|---|
| Provider Enumeration Date | 01/27/2022 |
| Last Update Date | 06/09/2023 |
| Certification Date | 06/09/2023 |
| Medicare PECOS PAC ID | 6204184997 |
|---|---|
| Medicare Enrollment ID | O20210930001981 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477206886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
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