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4404 W Cumberland Ave Middlesboro KY 40965-2626 | |
(606) 242-8820 | |
(606) 242-8825 |
Full Name | |
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Speciality | Clinic/Center |
Location | 4404 W Cumberland Ave, Middlesboro, Kentucky |
Authorized Official Name and Position | Chad Stevens (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 6065269005 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1019 Cumberland Falls Hwy Ste B201 Corbin KY 40701-2793 Ph: () - | 4404 W Cumberland Ave Middlesboro KY 40965-2626 Ph: (606) 242-8820 |
NPI Number | 1356987978 |
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Provider Enumeration Date | 11/19/2019 |
Last Update Date | 06/28/2024 |
Medicare PECOS PAC ID | 3870654064 |
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Medicare Enrollment ID | O20200225000721 |
Identifier | Type | State | Issuer |
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1356987978 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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