PENNYROYAL HEALTHCARE SERVICES, INC. (NPI# 1720454507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720454507 |
| Entity Type | Organization |
| Organization Name | PENNYROYAL HEALTHCARE SERVICES, INC. |
| Other Organization Name | PENNYROYAL HEALTHCARE SERVICE INC. |
| Practice Address |
244 Thompsonville Ln Oak Grove KY 42262-8250 |
| Mailing Address |
310 Hawthorne St Princeton KY 42445-1622 |
| Practice Telephone | 2703652227 |
| Practice Fax Number | 2703652559 |
| Mailing Telephone | 2703650227 |
| Mailing Fax Number | 2703652559 |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2018-03-16 |
| Authorized Official Name | KECIA FULCHER (CEO) |
| Authorized Official Telephone | 2703650227 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Pennyroyal Healthcare Service Inc. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124319942 | Pennyroyal Healthcare Services, Inc. | Clinic/Center | 1102 S Virginia St, Hopkinsville, KY 42240-3579 | 2011-04-27 |
| Street Address |
244 THOMPSONVILLE LN |
| City | OAK GROVE |
| State | KY |
| Zip Code | 42262-8250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023381969 | Jennifer Jean Johnson | Nurse Practitioner | 1654 Hugh Hunter Rd #20, Oak Grove, KY 42262 | 2012-02-22 |
| 1053602367 | Jabez Empowerment, LLC | In Home Supportive Care | 175 Stateline Road, Suite 4, Oak Grove, KY 42262 | 2011-04-21 |
| 1215171251 | Kimberly Cecil-riddle | Nurse Practitioner | 2801 Walter Garrett Lane, Oak Grove, KY 42262 | 2009-04-21 |
| 1598105488 | Randi Arlene Carr | Developmental Therapist | 304 Wilson Dr, Oak Grove, KY 42262-4210 | 2013-06-25 |
| 1780714956 | Maleka Monique Holmes | Social Worker | 180 Mandarin Dr, Oak Grove, KY 42262-7215 | 2007-03-06 |
| 1699129486 | Akeisha Danielle Peek | Developmental Therapist | 503 Gainey Dr, Oak Grove, KY 42262-8259 | 2016-04-18 |
| 1366859803 | Air Affiliates, Inc. | Durable Medical Equipment & Medical Supplies | 175 Stateline Rd Ste R-4, Oak Grove, KY 42262-8288 | 2014-07-16 |
| 1538482773 | Eddie A Manley | Nurse Practitioner | 175 Stateline Rd, Oak Grove, KY 42262-8288 | 2010-03-02 |
| 1902189541 | Priority Care Associates | Nurse Practitioner | 175 Stateline Rd, Oak Grove, KY 42262-8288 | 2011-09-20 |
| 1891712139 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 14800 Fort Campbell Blvd, Oak Grove, KY 42262-8304 | 2006-07-16 |
| Find all providers in zip 42262 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
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| 1710584925 | Sterling Health Solutions Inc | Clinic/Center | 3339 Lexington Rd, Paris, KY 40361-1038 | 2020-10-01 |
| 1255938460 | Sterling Health Solutions Inc | Clinic/Center | 3341 Lexington Rd, Paris, KY 40361-1038 | 2020-10-01 |
| 1831705995 | Sterling Health Solutions Inc | Clinic/Center | 369 Bethlehem Rd, Paris, KY 40361-2493 | 2020-09-23 |
| 1053926394 | A Plus Family Healthcare LLC | Clinic/Center | 220 Wildcat Way, Brownsville, KY 42210-9032 | 2020-09-14 |
| 1174138689 | A Plus Family Healthcare LLC | Clinic/Center | 5720 Ky Highway 259 N, Sweeden, KY 42285-7106 | 2020-09-11 |
| 1851901656 | Sterling Health Solutions Inc | Clinic/Center | 506 Maysville Rd Ste 2, Mount Sterling, KY 40353-9317 | 2020-08-06 |
| 1639797665 | Cumberland Family Medical Center, Inc. | Clinic/Center | 478 Whirlaway Drive, Suite 200, Davnille, KY 40422-9037 | 2020-07-07 |
| 1275160376 | Cumberland Family Medical Center, Inc. | Clinic/Center | 323 Morningside Drive, Elizabethtown, KY 42701-1739 | 2020-03-26 |
| Find all providers with the same taxonomy | ||||
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| 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.