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General NPI Number Information
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NPI Number | 1073310702
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Entity Type | Organization
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Legal Business Name | MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 30 KY-15
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City | HAZARD
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State | KY
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Zip | 41701-4185
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Country | US
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Telephone | 606-633-4871
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 40
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City | WHITESBURG
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State | KY
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Zip | 41858-0040
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Country | US
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Telephone | 606-633-4871
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | DELENA P MILLER
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Credential |
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Telephone | 606-633-4823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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