Organization
ACK HEALTHCARE MANAGEMENT, LLC
Active
Other names
Saint Camillus Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES YOUNG (OWNER/MEMBER)
(812) 489-0862
Entity
Organization
Contact information
Practice address
1520 4TH ST, LEWISPORT, KY 42351
(270) 295-3890
(270) 295-3891
Mailing address
PO BOX 1099, OWENSBORO, KY 42302-1099
(502) 277-5170
(502) 277-5172
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18D2054463
CLIA
KY
05
—
7100295770
—
KY
Enumeration date
03/18/2014
Last updated
08/29/2019
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