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General NPI Number Information
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NPI Number | 1871763581
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Entity Type | Organization
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Legal Business Name | EAST KENTUCKY HEALTH SERVICE
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 566 HWY 899
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City | HINDMAN
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State | KY
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Zip | 41822
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Country | US
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Telephone | 606-785-3164
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Fax | 606-785-0107
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Provider Business Mailing Address
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Address Line | PO BOX 849
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City | HINDMAN
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State | KY
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Zip | 41822-0849
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Country | US
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Telephone | 606-785-3164
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Fax | 606-785-0107
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Authorized Official
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Title or Position | BILLING CLERK
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Name | JEAN ADAMS
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Credential |
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Telephone | 606-785-3164
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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 | 16312
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License Number State | KY
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