Organization
CCMH CORPORATION
Active
Other names
Warsaw Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA TOMLINSON (PRACTICE MANAGER)
(502) 732-3278
Entity
Organization
Contact information
Practice address
202 FRANKLIN STREET, WARSAW, KY 41095
(859) 567-2754
(859) 567-5108
Mailing address
309 11TH ST, CARROLLTON, KY 41008-1435
(502) 732-3230
(502) 732-3297
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01031469
IN
207Q00000X
Family Medicine Physician
18145
KY
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
23459
KY
363LF0000X
Family Nurse Practitioner
3284P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000697014
ANTHEM
KY
01
—
50030472
PASSPORT
KY
05
—
7100145920
—
KY
05
—
7100156490
—
KY
Enumeration date
07/07/2006
Last updated
05/11/2021
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