| Pennyroyal Healthcare Services, Inc. | |
|
244 Thompsonville Ln Oak Grove KY 42262-8250 | |
| (270) 365-2227 | |
| (270) 365-2559 |
| Full Name | Pennyroyal Healthcare Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 244 Thompsonville Ln, Oak Grove, Kentucky |
| Authorized Official Name and Position | Kecia Fulcher (CEO) |
| Authorized Official Contact | 2703650227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pennyroyal Healthcare Services, Inc. 310 Hawthorne St Princeton KY 42445-1622 Ph: (270) 365-0227 | Pennyroyal Healthcare Services, Inc. 244 Thompsonville Ln Oak Grove KY 42262-8250 Ph: (270) 365-2227 |
| NPI Number | 1720454507 |
|---|---|
| Provider Enumeration Date | 08/17/2015 |
| Last Update Date | 03/16/2018 |
| Medicare PECOS PAC ID | 6002076700 |
|---|---|
| Medicare Enrollment ID | O20160113000071 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720454507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
St. Michael's Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2801 Walter Garrett Ln, Oak Grove, KY 42262 Phone: 270-640-5821 Fax: 844-270-5587 |