Organization · Type 2 NPI

Park Duvalle Community Health Center, Inc

Federally Qualified Health Center (FQHC) · Louisville, KY

NPI number 1639727951 Active

Practice location

1130 W Chestnut St
Louisville, KY 40203-2047

Call (502) 772-4401 Map

Mailing address

3015 Wilson Ave
Louisville, KY 40211-1969

Other practice locations

3015 Wilson Ave, Louisville, KY 40211-1969 · (502) 774-4401

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

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NPI record

NPI: 1639727951
Entity type: Organization (Type 2)
Issued: Aug 29, 2019
Last updated: Nov 2, 2021
Status: Active
Subpart: Yes of Park Duvalle Community Health Center, Inc

Other names

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Park Duvalle at Central Health Center · doing business as
Park Duvalle at Central Health Center · doing business as

Authorized official

Swannie Jett
CEO
(502) 774-4401

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About NPI 1639727951

Park Duvalle Community Health Center, Inc's National Provider Identifier is 1639727951, issued on Aug 29, 2019. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Louisville, KY. The record was last updated on Nov 2, 2021.