| Integrity Extended Healthcare Llc | |
|
308 W Maple Ave Lancaster KY 40444-1005 | |
| (248) 660-5830 | |
| (859) 224-2057 |
| Full Name | Integrity Extended Healthcare Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 308 W Maple Ave, Lancaster, Kentucky |
| Authorized Official Name and Position | Pallaki D Ravi (MEMBER) |
| Authorized Official Contact | 2486605830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrity Extended Healthcare Llc Po Box 10 Eubank KY 42567-0010 Ph: (248) 660-5830 | Integrity Extended Healthcare Llc 308 W Maple Ave Lancaster KY 40444-1005 Ph: (248) 660-5830 |
| NPI Number | 1093239469 |
|---|---|
| Provider Enumeration Date | 07/27/2017 |
| Last Update Date | 07/27/2017 |
| Medicare PECOS PAC ID | 8628341534 |
|---|---|
| Medicare Enrollment ID | O20170828004667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093239469 | NPI | - | NPPES |
| MPKY.0674-00 | Other | KY | MED MAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 46290 (Kentucky) | Primary |
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