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General NPI Number Information
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NPI Number | 1154328482
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Entity Type | Organization
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Legal Business Name | PATTIE A CLAY INFIRMARY ASSOCIATION
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 648 UNIVERSITY SHOPPING CTR
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City | RICHMOND
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State | KY
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Zip | 40475-2614
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Country | US
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Telephone | 859-623-1950
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Fax | 859-623-0619
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Provider Business Mailing Address
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Address Line | 648 UNIVERSITY SHOPPING CTR
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City | RICHMOND
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State | KY
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Zip | 40475-2614
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Country | US
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Telephone | 859-623-1950
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Fax | 859-623-0619
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. PAULA MAIONCHI
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Credential | MD
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Telephone | 859-623-1950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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