Provider Demographics
NPI:1568503936
Name:CONSOLIDATED HEALTH SYSTEMS
Entity Type:Organization
Organization Name:CONSOLIDATED HEALTH SYSTEMS
Other - Org Name:MARTIN COUNTY COMMUNITY CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER PROPERTIES CLINICS
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-886-7747
Mailing Address - Street 1:PO BOX 641627
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-1627
Mailing Address - Country:US
Mailing Address - Phone:866-275-8588
Mailing Address - Fax:
Practice Address - Street 1:1238 MIDDLE FORK RD
Practice Address - Street 2:
Practice Address - City:INEZ
Practice Address - State:KY
Practice Address - Zip Code:41224
Practice Address - Country:US
Practice Address - Phone:606-298-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38926261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6409752000Medicaid
KY65942518Medicaid
KY9476Medicare PIN
KY9476Medicare ID - Type UnspecifiedCONSOLIDATED HEALTH SYSTE