| Pennyroyal Healthcare Services, Inc | |
|
310 Hawthorne St Princeton KY 42445-1622 | |
| (270) 886-2205 | |
| (270) 886-0392 |
| Full Name | Pennyroyal Healthcare Services, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 310 Hawthorne St, Princeton, Kentucky |
| Authorized Official Name and Position | Kecia Fulcher (CEO/DIRECTOR) |
| Authorized Official Contact | 2708862205 |
| 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 310 Hawthorne St Princeton KY 42445-1622 Ph: (270) 886-2205 |
| NPI Number | 1740672617 |
|---|---|
| Provider Enumeration Date | 03/02/2015 |
| Last Update Date | 03/16/2018 |
| Medicare PECOS PAC ID | 6002076700 |
|---|---|
| Medicare Enrollment ID | O20140326000831 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740672617 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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