Provider Demographics
NPI:1083741730
Name:NEW HORIZONS FAMILY PRACTICE-WARSAW
Entity Type:Organization
Organization Name:NEW HORIZONS FAMILY PRACTICE-WARSAW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUR
Authorized Official - Suffix:
Authorized Official - Credentials:RNC
Authorized Official - Phone:502-484-3663
Mailing Address - Street 1:870 US HIGHWAY 42 W
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:KY
Mailing Address - Zip Code:41095-9323
Mailing Address - Country:US
Mailing Address - Phone:859-567-1591
Mailing Address - Fax:
Practice Address - Street 1:870 US HIGHWAY 42 W
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:KY
Practice Address - Zip Code:41095-9323
Practice Address - Country:US
Practice Address - Phone:859-567-1591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY900184261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY183453Medicare ID - Type Unspecified