| NPI | 1619066776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BOWMAN President 859-272-6682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: KY 100435) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 100435) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: KY 100435) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: KY 100435) | |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2007-10-02 |