AVANTE GARDE HEALTH CENTERS, LLC


Address: 72 Joe T Pettey Dr, Suite B, Russell Springs, KY 42642
Phone: 2708664357

AVANTE GARDE HEALTH CENTERS, LLC (NPI# 1407125016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407125016
Entity Type Organization
Organization Name AVANTE GARDE HEALTH CENTERS, LLC
Practice Address 72 Joe T Pettey Dr
Suite B
Russell Springs
KY 42642
Mailing Address Po Box 1383
Russell Springs
KY 42642-1383
Practice Telephone 2708664357
Practice Fax Number 2708584957
Mailing Telephone 2708664357
Mailing Fax Number 2708584957
Enumeration Date 2011-12-28
Last Update Date 2011-12-28
Authorized Official Name MRS. ANGELA Y CUNDIFF-ROY (OWNER)
Authorized Official Telephone 2708664357
Authorized Official Credential APRN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Office Location

Street Address 72 JOE T PETTEY DR
SUITE B
City RUSSELL SPRINGS
State KY
Zip Code 42642

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1619397775 Terri Susanne Jones Watkins Odpsc Optometrist 24 Caden Way, Suite 2, Russell Springs, KY 42642 2014-04-16
1548512247 Charles Lenwood Gore Pharmacist 1372 Snow Rd, Russell Springs, KY 42642 2012-10-05
1821392515 Southern Kentucky Medical Associates, Psc Nurse Practitioner 72 Joe T. Pettey Dr, Russell Springs, KY 42642 2011-01-10
1801106620 Premiertox, Inc. Clinical Medical Laboratory 2431 Lakeway Drive, Suite A1, Russell Springs, KY 42642 2010-10-14
1639404593 Rx Drug Monitoring Laboratory, LLC Clinical Medical Laboratory 660 Lakeway Drive, Suite A, Russell Springs, KY 42642 2009-10-11
1902079023 Russell County Hospital Specialist 92 Jt Pettey Drive, Russell Springs, KY 42642 2008-04-09
1225242779 Independent Speech Inc Physical Therapist 1831 Old Clear Springs Rd, Russell Springs, KY 42642 2007-05-10
1265571095 Lake Cumberland Area Development District Supports Brokerage 2374 Lakeway Drive, Russell Springs, KY 42642 2007-02-06
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City RUSSELL SPRINGS
Zip Code 42642

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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