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39 Jim Hill Service Rd Monticello KY 42633-7900 | |
(606) 678-0705 | |
(606) 678-2807 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 39 Jim Hill Service Rd, Monticello, Kentucky |
Authorized Official Name and Position | Eric E Loy (CEO) |
Authorized Official Contact | 2708641472 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1080 Burkesville KY 42717-1080 Ph: (270) 858-6644 | 39 Jim Hill Service Rd Monticello KY 42633-7900 Ph: (606) 678-0705 |
NPI Number | 1073063418 |
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Provider Enumeration Date | 10/10/2016 |
Last Update Date | 10/10/2016 |
Identifier | Type | State | Issuer |
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1073063418 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 700172 (Kentucky) | Primary |