1205665916 NPI number — PATEL MEDICAL CENTER PLLC

Table of content: ANNALISA YVETTE RAMIREZ MT (NPI 1902681190)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205665916 NPI number — PATEL MEDICAL CENTER PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATEL MEDICAL CENTER PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205665916
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
681 E HIGHWAY 60
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARDINSBURG
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40143-5802
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-756-2121
Provider Business Mailing Address Fax Number:
270-580-2199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
681 E HIGHWAY 60
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARDINSBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40143-5802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-756-2121
Provider Business Practice Location Address Fax Number:
270-580-2199
Provider Enumeration Date:
07/31/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GLASSCOCK
Authorized Official First Name:
TRACIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
270-547-7161

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)