PENNYROYAL HEALTHCARE SERVICES INC. NPI 1720454507

NPI Information

NPI: 1720454507
Provider Name: PENNYROYAL HEALTHCARE SERVICES, INC.

Former Legal Business Name: PENNYROYAL HEALTHCARE SERVICE INC.

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 18D2034189

Address:
244 THOMPSONVILLE LN
OAK GROVE, KY
ZIP 42262
Phone: (270) 365-2227
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PENNYROYAL HEALTHCARE SERVICES, INC. is a federally qualified health center (fqhc) clinic center in Oak Grove, KY. PENNYROYAL HEALTHCARE SERVICES, INC. NPI is 1720454507. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Pennyroyal Healthcare Service Inc..

The provider's business location address is:

244 THOMPSONVILLE LN
OAK GROVE, KY
ZIP 42262-250
Phone: (270) 365-2227
Fax: (270) 365-2559

The provider's authorized official is Kecia Fulcher .
The authorized official title is Ceo and has the following contact phone number (270) 365-0227.

The CLIA number assigned to this NPI record is 18D2034189 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/17/2015 and was last updated on 3/16/2018.

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	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

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

NPI Synchronization or Removal

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