Provider Demographics
NPI:1760980544
Name:HOPKINSVILLE FAMILY CARE PSC
Entity Type:Organization
Organization Name:HOPKINSVILLE FAMILY CARE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:H
Authorized Official - Last Name:MAJMUDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-220-0366
Mailing Address - Street 1:PO BOX 4005
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42241-4005
Mailing Address - Country:US
Mailing Address - Phone:270-220-0366
Mailing Address - Fax:
Practice Address - Street 1:315A W 16TH ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1903
Practice Address - Country:US
Practice Address - Phone:270-220-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty