Healthcare Provider Details

I. General information

NPI: 1174571756
Provider Name (Legal Business Name): PIKEVILLE MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 03/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 MAIN STREET
INEZ KY
41224
US

IV. Provider business mailing address

911 BYPASS RD
PIKEVILLE KY
41501-1689
US

V. Phone/Fax

Practice location:
  • Phone: 606-218-3500
  • Fax: 606-218-4560
Mailing address:
  • Phone: 606-218-3500
  • Fax: 606-218-4560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. DANNY HARRIS
Title or Position: CFO
Credential:
Phone: 606-218-3500