Provider Demographics
NPI:1093227431
Name:BRECKINRIDGE HEALTH INC
Entity Type:Organization
Organization Name:BRECKINRIDGE HEALTH INC
Other - Org Name:BHI WALK IN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:PORTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-756-6569
Mailing Address - Street 1:1011 OLD HIGHWAY 60
Mailing Address - Street 2:
Mailing Address - City:HARDINSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40143-2519
Mailing Address - Country:US
Mailing Address - Phone:270-756-6564
Mailing Address - Fax:270-580-2225
Practice Address - Street 1:1011 OLD HIGHWAY 60
Practice Address - Street 2:
Practice Address - City:HARDINSBURG
Practice Address - State:KY
Practice Address - Zip Code:40143-2519
Practice Address - Country:US
Practice Address - Phone:270-756-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRECKINRIDGE HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care