Healthcare Provider Details
I. General information
NPI: 1073936746
Provider Name (Legal Business Name): BEST CLINICAL FACILITY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/30/2014
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3415 BARDSTOWN RD STE 202
LOUISVILLE KY
40218-4605
US
IV. Provider business mailing address
3415 BARDSTOWN RD STE 202
LOUISVILLE KY
40218-4605
US
V. Phone/Fax
- Phone: 502-472-8363
- Fax:
- Phone: 502-472-8363
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
EDUARDO
A
CHONG
Title or Position: PRESIDENT
Credential:
Phone: 502-472-8363