Organization
PARK DUVALLE COMMUNITY HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SWANNIE JETT (CEO)
(502) 774-4401
Entity
Organization
Contact information
Practice address
3015 WILSON AVE, LOUISVILLE, KY 40211-1969
(502) 774-4401
(502) 772-4783
Mailing address
3015 WILSON AVE, LOUISVILLE, KY 40211-1969
(502) 774-4401
(502) 772-4783
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Enumeration date
04/19/2007
Last updated
11/02/2021
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