Organization
PRACTITIONER SERVICES PLLC
Active
Parent organization
PRACTITIONER SERVICES PLLC
Other names
Tru Healthcare
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRACTITIONER SERVICES PLLC
Authorized official
REAGEN LOUGHRAN APRN (OWNER/MEMBER)
(606) 862-8917
Entity
Organization
Contact information
Practice address
1102 S MAIN ST, LONDON, KY 40741-1529
(606) 770-5121
(606) 770-5199
Mailing address
1102 S MAIN ST, LONDON, KY 40741-1529
(606) 770-5121
(606) 770-5199
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B0-3893
CMS CERT# FOR RURAL HEALTH CLINIC DESIGNATION
KY
Enumeration date
03/24/2015
Last updated
08/29/2022
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