Healthcare Provider Details

I. General information

NPI: 1275908543
Provider Name (Legal Business Name): FAMILY HEALTH CARE ASSOCIATES 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2015
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3133 HIGHWAY 3630
ANNVILLE KY
40402-8738
US

IV. Provider business mailing address

PO BOX 1535
BARBOURVILLE KY
40906-5535
US

V. Phone/Fax

Practice location:
  • Phone: 606-364-2223
  • Fax: 606-645-1776
Mailing address:
  • Phone: 606-627-6371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GINA GOOD
Title or Position: OWNER
Credential: APRN
Phone: 606-627-6371