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General NPI Number Information
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NPI Number | 1578194890
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Entity Type | Organization
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Legal Business Name | PINEVILLE ER SERVICES
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 218 E PARK AVE
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City | PINEVILLE
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State | KY
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Zip | 40977-1720
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Country | US
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Telephone | 606-302-5464
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Fax | 606-545-0135
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Provider Business Mailing Address
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Address Line | 1625 NICHOLASVILLE RD APT 201
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City | LEXINGTON
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State | KY
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Zip | 40503-1446
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Country | US
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Telephone | 859-619-1372
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VELUPILLAI WIGNAKUMAR
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Credential | MD
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Telephone | 859-619-1372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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