Provider Demographics
NPI:1376088930
Name:COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SWAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-338-5777
Mailing Address - Street 1:480 HOPKINSVILLE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42345
Mailing Address - Country:US
Mailing Address - Phone:270-338-5777
Mailing Address - Fax:270-338-5765
Practice Address - Street 1:226 HOPKINSVILLE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:KY
Practice Address - Zip Code:42345
Practice Address - Country:US
Practice Address - Phone:270-377-3077
Practice Address - Fax:270-377-3002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty