OrganizationFamily Medical Care Of ManchesterFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address94 Marie Langdon Dr, Suite 1, Manchester, KY 40962-6353(606) 599-9955PECOS EnrollmentBased on the most recent information from CMS, provider Family Medical Care Of Manchester does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:36 AM.Profile DetailsProvider ID1700827599Provider TypeOrganizationFull NameFamily Medical Care Of ManchesterSubpartNoEnumeration Date6/10/2006Last Updated7/2/2008Contact InformationPractice LocationPractice Address94 Marie Langdon Dr, Suite 1, Manchester, KY 40962-6353Phone(606) 599-9955Fax(606) 599-9966Mailing LocationMailing Address94 Marie Langdon Dr, Suite 1, Manchester, KY 40962-6353Phone(606) 599-9955Fax(606) 599-9966Authorized OfficialNameIrwin, Douglas Gerardy (Owner)Phone(606) 599-9955Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense38637KentuckyProvider IdentifiersIDDescriptionIssuerIDC92418DescriptionOtherIssuerCUMBERLAND HEALTHCAREKentuckyID31000813DescriptionMedicaidIssuerUnlistedKentuckyID020252900DescriptionOtherIssuerBLACK LUNG GROUP #KentuckyID1168920DescriptionOtherIssuerPASSPORT GROUP PROVIDER #KentuckyID000000195439DescriptionOtherIssuerBLUE CROSS/BLUE SHIELDKentucky