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Organization
FIRST STOP URGENT CARE CENTER PSC
Active
Organization
FIRST STOP URGENT CARE CENTER PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAMLESH C DAVE MD (OWNER/MEDICAL DIRECTOR)
(502) 693-2465
Entity
Organization
Contact information
Practice address
1006 NEW MOODY LN, LAGRANGE, KY 40031-9122
(502) 222-0028
(502) 222-0029
Mailing address
1006 NEW MOODY LN, LAGRANGE, KY 40031-9122
(502) 222-0028
(502) 222-0029
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000344868
ANTHEM
KY
05
—
1D31001092
—
KY
01
—
2694766000
PASSPORT ADVANTAGE
KY
01
—
500009943
PASSPORT
KY
01
—
611378102
COMMERCIAL
KY
01
—
9241
MEDICARE
KY
01
—
DD0597
RAILROAD MEDICARE
KY
Enumeration date
09/20/2006
Last updated
02/24/2014
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