Organization
KENTON HEALTHCARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALLEN CRAIG TSCHUDI (MANAGING MEMBER)
(502) 429-8062
Entity
Organization
Contact information
Practice address
353 WALLER AVE, LEXINGTON, KY 40504-2901
(859) 252-3558
(859) 233-0192
Mailing address
7400 NEW LAGRANGE RD, #100, LOUISVILLE, KY 40222-4870
(502) 429-8062
(502) 429-5980
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100113
KY
332BN1400X
Nursing Facility Supplies (DME)
100113
KY
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
100113
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12504569
—
KY
Enumeration date
10/03/2006
Last updated
02/20/2008
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