Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 145 Orchard St, Oneida, Kentucky |
Authorized Official Name and Position | Sissel Jacob (CEO/PRESIDENT) |
Authorized Official Contact | 6065985104 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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210 Marie Langdon Dr Manchester KY 40962-6388 Ph: (606) 598-5104 | 145 Orchard St Oneida KY 40972 Ph: (606) 847-4000 |
NPI Number | 1881112134 |
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Provider Enumeration Date | 09/07/2017 |
Last Update Date | 02/09/2023 |
Medicare PECOS PAC ID | 4486616141 |
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Medicare Enrollment ID | O20180313000053 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881112134 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |