Adult Immunization Management, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

ADULT IMMUNIZATION MANAGEMENT, LLC

Practice address

1010 Allen St
Suite 203
Owensboro, KY 42303-3025

Phone

(270) 663-1240

Fax

(270) 228-4400

NPI assigned

Dec 11, 2009

Last updated

Dec 2, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jerry Crabtree

Title

Owner

Phone

(270) 663-1240

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1508195041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1221",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423021221",
            "telephone_number": "270-663-1240",
            "fax_number": "270-228-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 ALLEN ST",
            "address_2": "SUITE 203",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423033025",
            "telephone_number": "270-663-1240",
            "fax_number": "270-228-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT IMMUNIZATION MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-11",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "CRABTREE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-663-1240",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Health Service Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.