Pinelake Physician Practice, Llc
LBN: Pinelake Physician Practice, Llc
Pinelake Physician Practice, Llc is an health care organization with primary practice located at 1111 Medical Center Cir , Mayfield KY 42066-1194. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty.
Pinelake Physician Practice, Llc can be contacted via phone (270) 251-4543, or through Bowman, Monica via phone (615) 920-7000.
Contact Information
Primary practice address
1111 Medical Center Cir
Mayfield KY 42066-1194
Phone: (270) 251-4543
Fax: (270) 251-4544
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Ambulatory Health Care Facilities / Rural Health | 261QR1300X |
Profile Details
| NPI number | 1295960532 |
|---|---|
| LBN Legal business name | Pinelake Physician Practice, Llc |
| DBA Doing business as | |
| Authorized official | Bowman, Monica |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 15th, 2009 |
| Last updated | May 8th, 2023 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295960532 | NPPES |
| Kentucky | Other | 000000618910 | ANTHEM |
| Kentucky | MEDICAID | 7100335050 | ANTHEM |
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