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Organization

FORTUNE FIRST ASSIST LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBIN FORTUNE SAC (PRESIDENT)
(270) 369-8984
Entity
Organization

Contact information

Practice address
5099 SPORTSMAN LAKE RD, ELIZABETHTOWN, KY 42701-8216
(270) 369-8984
(270) 369-8562
Mailing address
5099 SPORTSMANS LAKE RD, ELIZABETHTOWN, KY 42701
(270) 369-8984
(270) 369-8562

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000215944
BLUE CROSS BLUE SHIELD
KY
Enumeration date
04/27/2007
Last updated
08/22/2020
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