Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 12579 Main St, Martin, 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 | 12579 Main St Martin KY 41649-7400 Ph: (606) 285-0681 |
NPI Number | 1174016281 |
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Provider Enumeration Date | 06/13/2018 |
Last Update Date | 09/18/2024 |
Medicare PECOS PAC ID | 8123293818 |
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Medicare Enrollment ID | O20180815002381 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174016281 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Mountain Comprehensive Care Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11206 Main St, Martin, KY 41649 Phone: 606-285-3142 | |
G.m. Majmundar Psc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11217 Main Street, Martin, KY 41649 Phone: 606-285-9000 Fax: 606-285-9484 |