| Organization Name: | PRESTONSBURG HEALTH CENTER, INC. |
| NPI Number: | 1053646745 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAURA JEAN HAZELTINE (INCORPORATOR) |
| Mailing Address: | 113 Regency Park Prestonsburg |
| State: | KY US |
| Postal Code: | 416539127 |
| Phone Number: | 6068863077 |
| Fax Number: | 6068863078 |
| NPI Enumeration Date: | 10/13/2009 |
| NPI Last Update Date: | 10/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 25775 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |