Healthcare Provider Details

I. General information

NPI: 1972178135
Provider Name (Legal Business Name): PIKEVILLE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 BYPASS RD BUILDING E SUITE 2
PIKEVILLE KY
41501-1689
US

IV. Provider business mailing address

PO BOX 2917
PIKEVILLE KY
41502-2917
US

V. Phone/Fax

Practice location:
  • Phone: 888-762-5979
  • Fax: 606-218-4759
Mailing address:
  • Phone: 888-762-5979
  • Fax: 606-218-4759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE HAGY
Title or Position: CFO
Credential:
Phone: 606-218-3974