Healthcare Provider Details

I. General information

NPI: 1982604518
Provider Name (Legal Business Name): PAINTSVILLE INVESTORS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 EUCLID AVE
PAINTSVILLE KY
41240-8645
US

IV. Provider business mailing address

1025 EUCLID AVE
PAINTSVILLE KY
41240-8645
US

V. Phone/Fax

Practice location:
  • Phone: 606-789-5808
  • Fax: 606-789-1813
Mailing address:
  • Phone: 606-789-5808
  • Fax: 606-789-1813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number100688
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number7100209150
License Number StateKY

VIII. Authorized Official

Name: MR. BRYAN FITZPATRICK
Title or Position: CFO
Credential:
Phone: 606-789-5808