Provider Demographics
NPI:1790166577
Name:BEFREE NOW CENTERS
Entity Type:Organization
Organization Name:BEFREE NOW CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, MSN
Authorized Official - Phone:859-967-9486
Mailing Address - Street 1:1890 STAR SHOOT PKWY
Mailing Address - Street 2:SUITE 170, PMB 348
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-4566
Mailing Address - Country:US
Mailing Address - Phone:859-967-9486
Mailing Address - Fax:859-368-7780
Practice Address - Street 1:2387 PROFESSIONAL HEIGHTS DR
Practice Address - Street 2:SUITE 10
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3004
Practice Address - Country:US
Practice Address - Phone:859-967-9486
Practice Address - Fax:859-368-7780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY=========OtherEIN