Kentucky Mountain Health Alliance, Inc. | |
279 E Main St Hazard KY 41701-1920 | |
(606) 487-9505 | |
(606) 436-0071 |
Full Name | Kentucky Mountain Health Alliance, Inc. |
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Speciality | Clinic/Center |
Location | 279 E Main St, Hazard, Kentucky |
Authorized Official Name and Position | Ellen Vance (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 6064879505 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kentucky Mountain Health Alliance, Inc. 279 E Main St Ste 300 Hazard KY 41701-1920 Ph: (606) 487-9505 | Kentucky Mountain Health Alliance, Inc. 279 E Main St Hazard KY 41701-1920 Ph: (606) 487-9505 |
NPI Number | 1407043979 |
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Provider Enumeration Date | 09/28/2007 |
Last Update Date | 08/20/2024 |
Medicare PECOS PAC ID | 8123112687 |
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Medicare Enrollment ID | O20070914000632 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407043979 | 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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