| Park Duvalle Community Health Center, Inc | |
|
500 W Broadway St Eminence KY 40019-1201 | |
| (502) 772-5034 | |
| Not Available |
| Full Name | Park Duvalle Community Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 500 W Broadway St, Eminence, Kentucky |
| Authorized Official Name and Position | Swannie Jett (CEO) |
| Authorized Official Contact | 5027744401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Duvalle Community Health Center, Inc 3015 Wilson Ave Louisville KY 40211-1969 Ph: (502) 774-4401 | Park Duvalle Community Health Center, Inc 500 W Broadway St Eminence KY 40019-1201 Ph: (502) 772-5034 |
| NPI Number | 1851957252 |
|---|---|
| Provider Enumeration Date | 05/13/2019 |
| Last Update Date | 08/01/2023 |
| Medicare PECOS PAC ID | 1658268974 |
|---|---|
| Medicare Enrollment ID | O20200310000057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851957252 | NPI | - | NPPES |
| 31000011 | Medicaid | KY | |
| 31000920 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
First You Medical Center Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 151 E Broadway St, Eminence, KY 40019 Phone: 502-845-6288 Fax: 888-310-2675 |