| Grace Sbhc Middlesboro Elementary School | |
|
3400 Cumberland Ave Middlesboro KY 40965-2610 | |
| (606) 242-8860 | |
| (606) 242-8865 |
| Full Name | Grace Sbhc Middlesboro Elementary School |
|---|---|
| Speciality | Clinic/Center |
| Location | 3400 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 |
|---|---|
| Grace Sbhc Middlesboro Elementary School 1019 Cumberland Falls Hwy Ste B201 Corbin KY 40701-2793 Ph: () - | Grace Sbhc Middlesboro Elementary School 3400 Cumberland Ave Middlesboro KY 40965-2610 Ph: (606) 242-8860 |
| NPI Number | 1447896063 |
|---|---|
| Provider Enumeration Date | 11/19/2019 |
| Last Update Date | 06/28/2024 |
| Medicare PECOS PAC ID | 3870654064 |
|---|---|
| Medicare Enrollment ID | O20200225000413 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447896063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Grace Sbhc Middlesboro Middle School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4400 W Cumberland Ave, Middlesboro, KY 40965 Phone: 606-242-8880 Fax: 606-242-8885 | |
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