Provider Demographics
NPI:1245420934
Name:HANDY MEDICAL, LLC
Entity Type:Organization
Organization Name:HANDY MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:JEANE
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-819-8709
Mailing Address - Street 1:101 BUCK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40067-6674
Mailing Address - Country:US
Mailing Address - Phone:502-819-8709
Mailing Address - Fax:502-722-5551
Practice Address - Street 1:101 BUCK CREEK RD
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:KY
Practice Address - Zip Code:40067-6674
Practice Address - Country:US
Practice Address - Phone:502-819-8709
Practice Address - Fax:502-722-5551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-28
Last Update Date:2007-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY279690302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization