MEDICARE: GINKGO GARDEN INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center	264207	KY

General Provider Information

NPI Number	:	1356429542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GINKGO GARDEN INC

Provider Business Mailing Address
First Line	:	462 BARKLEY DR
Second Line	:
City	:	GRAND RIVERS
State	:	KY
Zip	:	42045
Country	:	US
Telephone Number	:	270-362-5009
Fax Number	:	928-563-5009

Provider Business Practice Location Address
First Line	:	462 BARKLEY DR
Second Line	:
City	:	GRAND RIVERS
State	:	KY
Zip	:	42045
Country	:	US
Telephone Number	:	270-362-5009
Fax Number	:	928-563-5009

Authorized Official
Title or Position	:	OWNER
Name	:	MARY COUILLARD
Credential	:	PHD ARNP
Telephone Number	:	270-362-5009

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1578549184 — LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC.
Practice Location Address:

1860 JH OBRYAN AVE
GRAND RIVERS, KY
42045-9049

Practice Phone: 703-628-2462
Practice Fax: 270-362-9757

1003892548 — MR. KHAI C TRUONG M.D.
Practice Location Address:

1860 JH OBRYAN AVE
GRAND RIVERS, KY
42045-9049

Practice Phone: 270-362-8246
Practice Fax: 270-362-9757

1669612008 — LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC.
Practice Location Address:

1860 J.H. O'BRYAN AVE.
GRAND RIVERS, KY
42045

Practice Phone: 270-362-8246
Practice Fax: 270-362-9757

1255922498 — MATTHEW CASH FLETCHER
Practice Location Address:

1860 JH OBRYAN AVE
GRAND RIVERS, KY
42045-9049

Practice Phone: 270-362-8246
Practice Fax: 270-362-9757

1528739240 — KIMBERLY ROWLAND
Practice Location Address:

976 VANHOOSER RD
GRAND RIVERS, KY
42045-9162

Practice Phone: 270-562-0422
Practice Fax:

1336949452 — SUSAN RITCHIE HOLT DI
Practice Location Address:

762 ROLLING MEADOWS RD
GRAND RIVERS, KY
42045-9194

Practice Phone: 270-816-0866
Practice Fax:

Directions to “GINKGO GARDEN INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.