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General NPI Number Information
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NPI Number | 1497199368
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Entity Type | Organization
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Legal Business Name | OLDHAM COUNTY MINISTERIAL ASSOCIATION
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Dates
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Enumeration Date | 04/23/2013
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Last Update Date | 04/23/2013
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Provider Practice Location Address
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Address Line | 1025 SANIBEL WAY SUITE E
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City | LA GRANGE
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State | KY
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Zip | 40031-9156
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Country | US
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Telephone | 502-225-6711
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Fax | 502-225-6757
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Provider Business Mailing Address
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Address Line | 1025 SANIBEL WAY SUITE E
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City | LA GRANGE
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State | KY
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Zip | 40031-9156
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Country | US
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Telephone | 502-225-6711
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Fax | 502-225-6757
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Authorized Official
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Title or Position | CLINIC ADMINISTRATOR
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Name | MRS. JANET R WARREN
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Credential |
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Telephone | 502-225-6711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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