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General NPI Number Information
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NPI Number | 1609064468
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH CARE, LLC
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 60 LAUREL RDG CEDAR TRACE
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City | PRESTONSBURG
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State | KY
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Zip | 41653-8378
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Country | US
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Telephone | 606-886-0805
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Fax |
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Provider Business Mailing Address
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Address Line | 126 TRIVETTE DR SUITE 102
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City | PIKEVILLE
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State | KY
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Zip | 41501-1275
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Country | US
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Telephone | 606-432-0051
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Fax | 606-437-9540
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LINDA E WILLIAMS
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Credential | ARNP
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Telephone | 606-886-0805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 2675P
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License Number State | KY
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