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17644 South Highway 421 Big Creek KY 40914 | |
(606) 598-6196 | |
(606) 598-1340 |
Full Name | |
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Speciality | Clinic/Center |
Location | 17644 South Highway 421, Big Creek, 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 |
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17644 South Highway 421 Big Creek KY 40914 Ph: (606) 598-6196 | 17644 South Highway 421 Big Creek KY 40914 Ph: (606) 598-6196 |
NPI Number | 1790060820 |
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Provider Enumeration Date | 10/20/2011 |
Last Update Date | 09/19/2024 |
Medicare PECOS PAC ID | 8123293818 |
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Medicare Enrollment ID | O20111209000165 |
Identifier | Type | State | Issuer |
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1790060820 | NPI | - | NPPES |
7100215330 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |