Organization Name: | PRIMARY CARE CENTERS OF EASTERN KENTUCKY, LLC |
NPI Number: | 1891841961 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MELANIE LUTTRELL (CREDENTIALING COLLECTIONS MGR) |
Mailing Address: | 21992 Main St Hyden |
State: | KY US |
Postal Code: | 417498567 |
Phone Number: | 6066725200 |
Fax Number: | |
NPI Enumeration Date: | 01/25/2007 |
NPI Last Update Date: | 11/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |