Basic Information
Provider Information
NPI: 1508342965
EntityType: 2
ReplacementNPI:  
OrganizationName: STERLING HEALTH SOLUTIONS INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: STERLING CROSSROADS - BATH
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 236 W MAIN ST
Address2:  
City: MOUNT STERLING
State: KY
PostalCode: 403531348
CountryCode: US
TelephoneNumber: 8594047686
FaxNumber: 8592744312
Practice Location
Address1: 521 E HIGH ST
Address2:  
City: OWINGSVILLE
State: KY
PostalCode: 403602122
CountryCode: US
TelephoneNumber: 8594047686
FaxNumber: 8594988160
Other Information
ProviderEnumerationDate: 07/18/2018
LastUpdateDate: 06/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CONRAD
AuthorizedOfficialFirstName: ALEX
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CEO/EXECUTIVE DIRECTOR
AuthorizedOfficialTelephone: 8594047686
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QF0400X700245KYY Ambulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)

ID Information
IDTypeStateIssuerDescription
710023396005KY MEDICAID


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