Adult Immunization Management, LLC

Organization Active NPI Health Service Clinic/Center · Owensboro, KY

NPI 1508195041 · NPPES record last updated Dec 2, 2015

Key facts

NPI
1508195041
Entity type
Organization (NPI type 2)
Primary specialty
Health Service Clinic/Center 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
Organization subpart
No

Authorized official

Name
Mr. Jerry Crabtree
Title
Owner
Phone
(270) 663-1240

National Provider Directory

Locations

3525 Frederica St
Ste 8
Owensboro, KY 42301
Phone (270) 316-6347

1010 Allen St
Ste 203
Owensboro, KY 42303
Phone (270) 663-1240

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Yes

Addresses

Primary practice location

1010 Allen St
Suite 203
Owensboro, KY 42303-3025

Mailing address

PO Box 1221
Owensboro, KY 42302-1221
Phone (270) 663-1240

Other identifiers

IdentifierTypeStateIssuer
7100123610MedicaidKY

Other providers in Owensboro, KY

All providers in Owensboro, KY · Health Service Clinic/Center in Kentucky

Sources for this page

Verify at the official NPI Registry.