Healthcare Provider Details

I. General information

NPI: 1891599502
Provider Name (Legal Business Name): PIKEVILLE MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 MOORE AVE
CHEYENNE WY
82001-1262
US

IV. Provider business mailing address

PO BOX 432
PIKEVILLE KY
41502-0432
US

V. Phone/Fax

Practice location:
  • Phone: 606-430-3500
  • Fax:
Mailing address:
  • Phone: 606-430-3500
  • Fax: 606-432-5422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE HAGY
Title or Position: CFO
Credential:
Phone: 606-430-3519