Basic Information
| Provider Information | |||||||||
| NPI: | 1366790099 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STERLING HEALTH SOLUTIONS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 236 W MAIN ST | ||||||||
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| City: | MOUNT STERLING | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403531348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8594047686 | ||||||||
| FaxNumber: | 8592744312 | ||||||||
| Practice Location | |||||||||
| Address1: | 209 N MAYSVILLE ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MOUNT STERLING | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403531179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8594047686 | ||||||||
| FaxNumber: | 8594988160 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2012 | ||||||||
| LastUpdateDate: | 06/26/2019 | ||||||||
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| AuthorizedOfficialLastName: | CONRAD | ||||||||
| AuthorizedOfficialFirstName: | ALEX | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO/EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8594047686 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QC1500X | N | Ambulatory Health Care Facilities | Clinic/Center | Community Health | 261QP2300X | N | Ambulatory Health Care Facilities | Clinic/Center | Primary Care | 363LF0000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 207RA0000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Adolescent Medicine | 261QF0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
ID Information
| ID | Type | State | Issuer | Description | 7100233960 | 05 | KY | MEDICAID |