Provider Demographics
NPI:1487667770
Name:HO MEDICAL & CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:HO MEDICAL & CHIROPRACTIC CORPORATION
Other - Org Name:HO PHYSICIANS SERVICES CORPORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:606-549-0123
Mailing Address - Street 1:841 US HWY 25W SOUTH
Mailing Address - Street 2:STE 5
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40769
Mailing Address - Country:US
Mailing Address - Phone:606-549-0123
Mailing Address - Fax:606-549-5995
Practice Address - Street 1:841 US HWY 25W SOUTH
Practice Address - Street 2:STE 5
Practice Address - City:WILLIAMSBURG
Practice Address - State:KY
Practice Address - Zip Code:40769
Practice Address - Country:US
Practice Address - Phone:606-549-0123
Practice Address - Fax:606-549-5995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY35-001692Medicaid
KY85900322Medicaid
KY35-001692Medicaid
KY7872Medicare ID - Type UnspecifiedPART B