PARK DUVALLE COMMUNITY HEALTH CENTER INC NPI 1811545403

NPI Information

NPI: 1811545403
Provider Name: PARK DUVALLE COMMUNITY HEALTH CENTER, INC

Doing Business As: PARK DUVALLE AT PLEASURE RIDGE PARK HEALTH CENTER

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
5901 GREENWOOD RD
LOUISVILLE, KY
ZIP 40258
Phone: (502) 774-4401
Get Directions

PARK DUVALLE COMMUNITY HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Louisville, KY. PARK DUVALLE COMMUNITY HEALTH CENTER, INC NPI is 1811545403. The provider is registered as an organization entity type.
The provider Is Doing Business As Park Duvalle At Pleasure Ridge Park Health Center.

The provider's business location address is:

5901 GREENWOOD RD
LOUISVILLE, KY
ZIP 40258-409
Phone: (502) 774-4401

The provider's authorized official is Swannie Jett .
The authorized official title is Ceo and has the following contact phone number (502) 774-4401.

The enumeration date for this NPI number is 8/28/2019 and was last updated on 11/2/2021.

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

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	31000011	MEDICAID	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: 4/28/2024

NPI Synchronization or Removal

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