| |
9879 Ky Route 122 Mc Dowell KY 41647-6026 | |
(606) 377-3462 | |
(606) 377-3466 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 9879 Ky Route 122, Mc Dowell, Kentucky |
Authorized Official Name and Position | Hollie Harris (PRESIDENT AND CEO) |
Authorized Official Contact | 8592262511 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
100 Airport Gardens Rd Hazard KY 41701-9529 Ph: (606) 487-7524 | 9879 Ky Route 122 Mc Dowell KY 41647-6026 Ph: (606) 377-3462 |
NPI Number | 1669078879 |
---|---|
Provider Enumeration Date | 12/11/2020 |
Last Update Date | 09/20/2024 |
Medicare PECOS PAC ID | 0840107835 |
---|---|
Medicare Enrollment ID | O20210316002565 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669078879 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |