Organization
ISLAND MEDICAL HARRODSBURG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN DE LA PRIDA (CFO)
(631) 514-7600
Entity
Organization
Contact information
Practice address
464 LINDEN AVE, HARRODSBURG, KY 40330-1882
(859) 734-5441
Mailing address
PO BOX 74534, CLEVELAND, OH 44194-0002
(330) 656-5911
(330) 656-5901
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/12/2016
Last updated
11/14/2017
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