Healthcare Provider Details

I. General information

NPI: 1548963309
Provider Name (Legal Business Name): POOLE'S CLINICAL SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 05/07/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 W BROAD ST
CENTRAL CITY KY
42330-1538
US

IV. Provider business mailing address

PO BOX 91
LIVERMORE KY
42352-0091
US

V. Phone/Fax

Practice location:
  • Phone: 270-754-1545
  • Fax: 270-754-9069
Mailing address:
  • Phone: 270-486-1534
  • Fax: 270-278-2369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RON STEVEN POOLE
Title or Position: PRESIDENT/OWNER/PHARMACIST
Credential: R.PH.
Phone: 270-543-3886