| Shelby Valley Clinic | |
|
178 Douglas Pkwy Shelby Valley Clinic Pikeville KY 41501-6970 | |
| (606) 639-3135 | |
| (606) 639-3136 |
| Full Name | Shelby Valley Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 178 Douglas Pkwy, Pikeville, Kentucky |
| Authorized Official Name and Position | Boyce Dean Shofner (CEO) |
| Authorized Official Contact | 6068868546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelby Valley Clinic 1709 Ky Route 321 Suite 3 Big Sandy Health Care Inc Prestonsburg KY 41653-9101 Ph: (606) 886-8546 | Shelby Valley Clinic 178 Douglas Pkwy Shelby Valley Clinic Pikeville KY 41501-6970 Ph: (606) 639-3135 |
| NPI Number | 1700828597 |
|---|---|
| Provider Enumeration Date | 06/13/2006 |
| Last Update Date | 03/09/2023 |
| Medicare PECOS PAC ID | 1951211218 |
|---|---|
| Medicare Enrollment ID | O20100917000693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700828597 | NPI | - | NPPES |
| 31000417 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 700058 (Kentucky) | Primary |
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