Provider Demographics
NPI:1730795261
Name:HOMETOWN URGENT CARE
Entity type:Organization
Organization Name:HOMETOWN URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLDIRON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:606-273-1251
Mailing Address - Street 1:1540 S US HIGHWAY 421
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:KY
Mailing Address - Zip Code:40831-2501
Mailing Address - Country:US
Mailing Address - Phone:606-573-9939
Mailing Address - Fax:606-573-9940
Practice Address - Street 1:1540 SOUTH U.S. HWY 421 BY-PASS
Practice Address - Street 2:
Practice Address - City:HARLAN
Practice Address - State:KY
Practice Address - Zip Code:40831
Practice Address - Country:US
Practice Address - Phone:606-573-9939
Practice Address - Fax:606-573-9940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100705870Medicaid