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BROCK MEDICAL LLC NPI 1366003550


NPI Information

NPI: 1366003550
Provider Name: BROCK MEDICAL, LLC

Doing Business As: FIRST CARE CLINICS

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

Specialization: Rural Health

CLIA Number: 18D2240398

Address:
110 W JOHN ROWAN BLVD
BARDSTOWN, KY
ZIP 40004
Phone: (606) 716-6017
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BROCK MEDICAL, LLC is a rural health clinic center in Bardstown, KY. BROCK MEDICAL, LLC NPI is 1366003550. The provider is registered as an organization entity type.
The provider Is Doing Business As First Care Clinics.

The provider's business location address is:

110 W JOHN ROWAN BLVD
BARDSTOWN, KY
ZIP 40004-663
Phone: (606) 716-6017
Fax: (606) 261-2074

The provider's authorized official is Andrew Michael Deane .
The authorized official title is Vp Of Finance and has the following contact phone number (615) 600-3478.

The CLIA number assigned to this NPI record is 18D2240398 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/27/2019 and was last updated on 9/9/2022.


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
1261QR1300XClinic/CenterRural HealthYes

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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