Provider Demographics
NPI:1902189541
Name:PRIORITY CARE ASSOCIATES
Entity Type:Organization
Organization Name:PRIORITY CARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:931-302-9564
Mailing Address - Street 1:PO BOX 1371
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42241-1371
Mailing Address - Country:US
Mailing Address - Phone:931-302-9564
Mailing Address - Fax:
Practice Address - Street 1:175 STATELINE RD
Practice Address - Street 2:
Practice Address - City:OAK GROVE
Practice Address - State:KY
Practice Address - Zip Code:42262-8288
Practice Address - Country:US
Practice Address - Phone:270-302-9564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-20
Last Update Date:2014-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006470363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty