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General NPI Number Information
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NPI Number | 1366739526
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Entity Type | Organization
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Legal Business Name | FIRST ON SITE
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 275 E MAIN ST
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City | FRANKFORT
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State | KY
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Zip | 40601-2321
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Country | US
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Telephone | 502-564-5555
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Fax | 502-696-3996
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Provider Business Mailing Address
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Address Line | 275 E MAIN ST
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City | FRANKFORT
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State | KY
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Zip | 40601-2321
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Country | US
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Telephone | 502-564-5555
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Fax | 502-696-3996
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Authorized Official
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Title or Position | ASSISANT MANAGER
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Name | MS. GINA JENKINS JENKINS
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Credential |
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Telephone | 866-931-8999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number | 3006462
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License Number State | KY
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