Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 25 Eagle Lane, Hyden, Kentucky |
Authorized Official Name and Position | Chad Stevens (AO) |
Authorized Official Contact | 6065269005 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1019 Cumberland Falls Hwy Ste B201 Corbin KY 40701-2793 Ph: (606) 672-2337 | 25 Eagle Lane Hyden KY 41749 Ph: (606) 672-2337 |
NPI Number | 1679133391 |
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Provider Enumeration Date | 06/14/2019 |
Last Update Date | 06/28/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679133391 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |