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Organization
COMMUNITY HEALTH CLINIC, INC.
Active
Organization
COMMUNITY HEALTH CLINIC, INC.
Active
Other names
COMMUNITY HEALTH CLINIC OF HARDIN AND LARUE COUNTIES, Community Health Clinic, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA DAILEY (EXECUTIVE ASSISTANT)
(270) 763-9589
Entity
Organization
Contact information
Practice address
1113 WOODLAND DR, ELIZABETHTOWN, KY 42701-2749
(270) 763-9589
(270) 763-9689
Mailing address
1113 WOODLAND DR, ELIZABETHTOWN, KY 42701-2749
(270) 763-9589
(270) 763-9689
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
261QD0000X
Dental Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100744700
—
KY
Enumeration date
01/28/2019
Last updated
05/31/2022
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