Organization
CCMH CORPORATION
Active
Other names
Bedford Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHEILA TOMLINSON (DIRECTOR OF CLINICAL SERVICES)
(502) 732-3278
Entity
Organization
Contact information
Practice address
309 11TH ST, CARROLLTON, KY 41008-1435
(502) 662-0336
Mailing address
470 HIGHWAY 421 N, BEDFORD, KY 40006-8690
(502) 255-7732
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
900261
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000520562
ANTHEM
KY
01
—
50014776
PASSPORT
KY
05
—
7100010810
—
KY
Enumeration date
10/02/2007
Last updated
09/24/2021
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