MEDICARE: TAYLOR RURAL HEALTH, LLC

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	261QP2300X	Primary Care Clinic/Center	900046	KY
2	261QR1300X	Rural Health Clinic/Center		KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447581871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAYLOR RURAL HEALTH, LLC

Provider Business Mailing Address
First Line	:	805 BURKESVILLE ST
Second Line	:
City	:	COLUMBIA
State	:	KY
Zip	:	42728-1655
Country	:	US
Telephone Number	:	270-384-1110
Fax Number	:	270-384-3436

Provider Business Practice Location Address
First Line	:	805 BURKESVILLE ST
Second Line	:
City	:	COLUMBIA
State	:	KY
Zip	:	42728-1655
Country	:	US
Telephone Number	:	270-384-1110
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MS. JANE WHEATLEY
Credential	:	FACHE
Telephone Number	:	270-465-3561

Provider Enumeration Date	:	01/25/2010
Last Update Date	:	12/28/2016

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Directions to “TAYLOR RURAL HEALTH, LLC ” Practice Location

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