Provider Demographics
NPI:1699351163
Name:ACK HEALTHCARE MANAGEMENT LLC
Entity Type:Organization
Organization Name:ACK HEALTHCARE MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-489-0862
Mailing Address - Street 1:PO BOX 1099
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42302-1099
Mailing Address - Country:US
Mailing Address - Phone:423-339-2320
Mailing Address - Fax:423-339-2321
Practice Address - Street 1:1704 2ND ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-3366
Practice Address - Country:US
Practice Address - Phone:270-826-4433
Practice Address - Fax:270-826-4888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health