Organization
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH ALLEN SWAB (CFO)
(270) 338-5777
Entity
Organization
Contact information
Practice address
1497 NASHVILLE ROAD, RUSSELLVILLE, KY 42276
(270) 726-1266
(270) 726-1961
Mailing address
PO BOX 257, GREENVILLE, KY 42345-0257
(270) 338-5777
(270) 338-5765
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31000458
—
KY
Enumeration date
08/21/2019
Last updated
12/17/2019
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