BRECKINRIDGE HEALTH INC. NPI 1245236900

NPI Information

NPI: 1245236900
Provider Name: BRECKINRIDGE HEALTH, INC.

Doing Business As: CLOVERPORT HEALTH CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
209 ELM ST
CLOVERPORT, KY
ZIP 40111
Phone: (270) 788-3000
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BRECKINRIDGE HEALTH, INC. is a rural health clinic center in Cloverport, KY. BRECKINRIDGE HEALTH, INC. NPI is 1245236900. The provider is registered as an organization entity type.
The provider Is Doing Business As Cloverport Health Clinic.

The provider's business location address is:

209 ELM ST
CLOVERPORT, KY
ZIP 40111-324
Phone: (270) 788-3000
Fax: (270) 788-6201

The provider's authorized official is Mandy J Butler .
The authorized official title is Nurse Practitioner and has the following contact phone number (270) 788-3000.

The CLIA number assigned to this NPI record is 18D0909451 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/27/2005 and was last updated on 3/29/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center		900053	KENTUCKY	No
2	261QR1300X	Clinic/Center	Rural Health	900053	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1049478	OTHER	KENTUCKY	PASSPORT
2	35000587	MEDICAID	KENTUCKY
3	183412	MEDICARE ID-TYPE UNSPECIFIED	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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