Provider Demographics
NPI:1194279729
Name:FRONTLINE TRAINING CENTER, LLC
Entity type:Organization
Organization Name:FRONTLINE TRAINING CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SITE MANANGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:CCMA
Authorized Official - Phone:606-312-2436
Mailing Address - Street 1:1321 CUMBERLAND FALLS HWY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-2720
Mailing Address - Country:US
Mailing Address - Phone:877-366-8890
Mailing Address - Fax:788-248-6141
Practice Address - Street 1:1321 CUMBERLAND FALLS HWY
Practice Address - Street 2:SUITE 3
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2720
Practice Address - Country:US
Practice Address - Phone:877-366-8890
Practice Address - Fax:788-248-6141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care