| Organization Name: | MARTIN COUNTY COMMUNITY CARE CENTER |
| NPI Number: | 1982961165 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STACEY C SHY (PRESIDENT/CEO) |
| Mailing Address: | 1238 Middle Fork Rd Inez |
| State: | KY US |
| Postal Code: | 412240219 |
| Phone Number: | 3044291088 |
| Fax Number: | 3044293109 |
| NPI Enumeration Date: | 04/12/2012 |
| NPI Last Update Date: | 10/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 18-8911 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |