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3602 Cumberland Ave Ste B102 Middlesboro KY 40965-2614 | |
(606) 242-1577 | |
(606) 242-1578 |
Full Name | |
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Speciality | Clinic/Center |
Location | 3602 Cumberland Ave Ste B102, Middlesboro, Kentucky |
Authorized Official Name and Position | Hollie P Harris (PRESIDENT AND CEO) |
Authorized Official Contact | 8592262440 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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100 Airport Gardens Rd Hazard KY 41701-9529 Ph: (606) 487-7524 | 3602 Cumberland Ave Ste B102 Middlesboro KY 40965-2614 Ph: (606) 242-1577 |
NPI Number | 1801403092 |
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Provider Enumeration Date | 09/30/2020 |
Last Update Date | 09/20/2024 |
Medicare PECOS PAC ID | 0840107835 |
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Medicare Enrollment ID | O20071204000004 |
Identifier | Type | State | Issuer |
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1801403092 | NPI | - | NPPES |
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