| Mountain Comprehensive Care Center, Inc. | |
|
263 Ky Route 122 Martin KY 41649-9006 | |
| (606) 886-8572 | |
| (606) 886-4433 |
| Full Name | Mountain Comprehensive Care Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 263 Ky Route 122, Martin, Kentucky |
| Authorized Official Name and Position | Roxann Cordial (CREDENTIALING MANAGER) |
| Authorized Official Contact | 6068868572 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Comprehensive Care Center, Inc. 104 S Front Ave Prestonsburg KY 41653-1614 Ph: (606) 886-8572 | Mountain Comprehensive Care Center, Inc. 263 Ky Route 122 Martin KY 41649-9006 Ph: (606) 886-8572 |
| NPI Number | 1699456129 |
|---|---|
| Provider Enumeration Date | 07/27/2023 |
| Last Update Date | 07/27/2023 |
| Medicare PECOS PAC ID | 5294720553 |
|---|---|
| Medicare Enrollment ID | O20240206003210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699456129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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