Healthcare Provider Details

I. General information

NPI: 1619429818
Provider Name (Legal Business Name): ELLIOTT COUNTY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2016
Last Update Date: 11/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DAVID BLAIR BLVD
SANDY HOOK KY
41171
US

IV. Provider business mailing address

PO BOX 762 DAVID BLAIR BLVD
SANDY HOOK KY
41171
US

V. Phone/Fax

Practice location:
  • Phone: 606-738-5205
  • Fax:
Mailing address:
  • Phone: 606-738-5205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY D. BREWER
Title or Position: ASSISTANT DIRECTOR
Credential:
Phone: 606-674-6396