Community Care of Kentucky, Inc

Organization Active NPI General Practice Dentistry · Earlington, KY

NPI 1962880997 · NPPES record last updated Jan 15, 2016

Key facts

NPI
1962880997
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
COMMUNITY CARE OF KENTUCKY, INC
Practice address
122 S Lee Trover Todd Jr Hwy
Earlington, KY 42410-1557
Phone
(270) 383-5511
NPI assigned
May 11, 2015
Organization subpart
No

Authorized official

Name
Jenell Stump
Title
Manager, Licensing & Credentialing
Phone
(270) 383-5511

Corporate family (same tax ID) 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Community Care of Kentucky Inc (7 organizations share this tax ID)

Locations

122 S Lee Trover Todd Hwy
Earlington, KY 42410
Phone (270) 383-5511

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

122 S Lee Trover Todd Jr Hwy
Earlington, KY 42410-1557

Mailing address

PO Box 2369
Anniston, AL 36202-2369
Phone (256) 741-7340

Other providers in Earlington, KY

All providers in Earlington, KY · General Practice Dentistry in Kentucky

Sources for this page

Verify at the official NPI Registry.