Provider Demographics
NPI:1295563237
Name:KENTUCKY PREMIER PERSONAL CARE LLC
Entity type:Organization
Organization Name:KENTUCKY PREMIER PERSONAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:MCFERRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-392-5343
Mailing Address - Street 1:636 BIG SANDY RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:KY
Mailing Address - Zip Code:40456-7426
Mailing Address - Country:US
Mailing Address - Phone:606-392-5343
Mailing Address - Fax:606-770-6091
Practice Address - Street 1:636 BIG SANDY RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:KY
Practice Address - Zip Code:40456-7426
Practice Address - Country:US
Practice Address - Phone:606-392-5343
Practice Address - Fax:606-770-6091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care