MEDICARE: CENTRAL KY URGENT CARE CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363A00000X	Physician Assistant
2	363LF0000X	Family Nurse Practitioner
3	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1023535796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL KY URGENT CARE CENTER INC

Provider Business Mailing Address
First Line	:	103 KEYSTONE DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-7988
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 KEYSTONE DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-7988
Country	:	US
Telephone Number	:	513-449-9099
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BIJAYA GHIMIRE
Credential	:	MD
Telephone Number	:	606-813-1828

Provider Enumeration Date	:	08/24/2017
Last Update Date	:	11/18/2021

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