| Mercy Health Irvin Primary Care | |
|
1100 Richmond Road Irvine KY 40336-7231 | |
| (606) 723-7706 | |
| (606) 726-9410 |
| Full Name | Mercy Health Irvin Primary Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1100 Richmond Road, Irvine, Kentucky |
| Authorized Official Name and Position | Trena Lynn Stocker (PRESIDENT) |
| Authorized Official Contact | 8597790148 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Health Irvin Primary Care Po Box 636493 Cincinnati OH 45263-6493 Ph: (513) 981-5098 | Mercy Health Irvin Primary Care 1100 Richmond Road Irvine KY 40336-7231 Ph: (606) 723-7706 |
| NPI Number | 1811132525 |
|---|---|
| Provider Enumeration Date | 12/09/2008 |
| Last Update Date | 05/02/2019 |
| Medicare PECOS PAC ID | 2466592688 |
|---|---|
| Medicare Enrollment ID | O20091223000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811132525 | NPI | - | NPPES |
| 7100132150 | Medicaid | KY | |
| 000000652248 | Other | KY | ANTHEM |
| DQ5374 | Other | KY | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 900224 (Kentucky) | Primary |
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