Provider Demographics
NPI:1982113148
Name:A1 HEALTH CARE CLINIC
Entity type:Organization
Organization Name:A1 HEALTH CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARIQ
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-550-3720
Mailing Address - Street 1:PO BOX 910961
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-0961
Mailing Address - Country:US
Mailing Address - Phone:270-321-4616
Mailing Address - Fax:270-321-4619
Practice Address - Street 1:703 EAST MAIN STREET, # 8
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40444
Practice Address - Country:US
Practice Address - Phone:270-321-4616
Practice Address - Fax:270-321-4619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK155281OtherMEDICARE PTAN
KY000001121843OtherANTHEM ID