Provider Demographics
NPI:1275786071
Name:BARBOURVILLE FAMILY HEALTH CENTER
Entity Type:Organization
Organization Name:BARBOURVILLE FAMILY HEALTH CENTER
Other - Org Name:ACCESS FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-546-4060
Mailing Address - Street 1:315 HOSPITAL DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906-7917
Mailing Address - Country:US
Mailing Address - Phone:606-546-4060
Mailing Address - Fax:606-546-9363
Practice Address - Street 1:315 HOSPITAL DR
Practice Address - Street 2:SUITE 2
Practice Address - City:BARBOURVILLE
Practice Address - State:KY
Practice Address - Zip Code:40906-7917
Practice Address - Country:US
Practice Address - Phone:606-546-4060
Practice Address - Fax:606-546-9363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100116370Medicaid
KY7100116370Medicaid
KY183972Medicare Oscar/Certification