Pine Knot Primary Healthy Kids Clinic | |
119 E Highway 2792 Pine Knot KY 42635-9159 | |
(844) 435-0900 | |
(270) 692-3559 |
Full Name | Pine Knot Primary Healthy Kids Clinic |
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Speciality | Clinic/Center |
Location | 119 E Highway 2792, Pine Knot, Kentucky |
Authorized Official Name and Position | Eric E Loy (CEO) |
Authorized Official Contact | 2708586655 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pine Knot Primary Healthy Kids Clinic Po Box 1080 Burkesville KY 42717-1080 Ph: (270) 858-6655 | Pine Knot Primary Healthy Kids Clinic 119 E Highway 2792 Pine Knot KY 42635-9159 Ph: (844) 435-0900 |
NPI Number | 1831747146 |
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Provider Enumeration Date | 08/29/2019 |
Last Update Date | 02/17/2020 |
Medicare PECOS PAC ID | 6305947789 |
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Medicare Enrollment ID | O20200415000930 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831747146 | NPI | - | NPPES |
7100017280 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Cumberland Family Clinic, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 57 Hogue Rd, Pine Knot, KY 42635 Phone: 606-310-9737 | |
Cumberland Family Medical Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6519 S Highway 1651, Pine Knot, KY 42635 Phone: 844-435-0900 Fax: 270-858-4029 |