Healthcare Provider Details

I. General information

NPI: 1679873400
Provider Name (Legal Business Name): CAREMORE PAIN MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 TEAYS BR
PAINTSVILLE KY
41240-8548
US

IV. Provider business mailing address

420 TEAYS BR PO BOX 443
PAINTSVILLE KY
41240-8548
US

V. Phone/Fax

Practice location:
  • Phone: 606-789-7246
  • Fax: 606-789-4392
Mailing address:
  • Phone: 606-789-7246
  • Fax: 606-789-4392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. GAYLA LEE FLETCHER
Title or Position: OFFICE MANAGER
Credential:
Phone: 606-789-7246