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1225 N Main St Monticello KY 42633-1902 | |
(606) 340-0740 | |
(606) 340-0742 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1225 N Main St, Monticello, Kentucky |
Authorized Official Name and Position | Logan Roy Antle (CEO) |
Authorized Official Contact | 6064255768 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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521 Crane Rd Somerset KY 42501-9503 Ph: (606) 425-5768 | 1225 N Main St Monticello KY 42633-1902 Ph: (606) 340-0740 |
NPI Number | 1013787910 |
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Provider Enumeration Date | 01/03/2024 |
Last Update Date | 01/03/2024 |
Identifier | Type | State | Issuer |
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1013787910 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |