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NPI Code Detail

MEDICARE: THAMES HEALTHCARE GROUP, LLC

MEDICARE: THAMES HEALTHCARE GROUP, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility100430KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12705895000OTHERKYPASSPORT ADVANTAGE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000000054459OTHERKYBCBS OF KY
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730115189
Entity Type Code : Organization
Provider Name (Legal Business Name) : THAMES HEALTHCARE GROUP, LLC
Provider Business Mailing Address
First Line : 6301 BASS RD
Second Line :
City : PROSPECT
State : KY
Zip : 40059-9384
Country : US
Telephone Number : 502-228-8359
Fax Number : 502-228-5469
Provider Business Practice Location Address
First Line : 6301 BASS RD
Second Line :
City : PROSPECT
State : KY
Zip : 40059-9384
Country : US
Telephone Number : 502-228-8359
Fax Number : 502-228-5469
Authorized Official
Title or Position : PRESIDENT
Name : MRS. KAREN G MCDANIEL
Credential :
Telephone Number : 252-523-9094
Provider Enumeration Date : 06/25/2006
Last Update Date : 07/14/2021

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Directions to “THAMES HEALTHCARE GROUP, LLC ” Practice Location

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