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NPI Code Detail

MEDICARE: MOUNTAIN COMPREHENSIVE HEALTH CORPORATION

MEDICARE: MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife
2122300000XDentist
3207Q00000XFamily Medicine Physician
4207R00000XInternal Medicine Physician
5207V00000XObstetrics & Gynecology Physician
6208000000XPediatrics Physician
7261QF0400XFederally Qualified Health Center (FQHC)
8363A00000XPhysician Assistant
9363L00000XNurse Practitioner
10261QP2300XPrimary Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417900242
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Provider Business Mailing Address
First Line : PO BOX 40
Second Line :
City : WHITESBURG
State : KY
Zip : 41858-0040
Country : US
Telephone Number : 606-633-4823
Fax Number : 606-633-1874
Provider Business Practice Location Address
First Line : 226 MEDICAL PLAZA LN
Second Line :
City : WHITESBURG
State : KY
Zip : 41858-7425
Country : US
Telephone Number : 606-633-4823
Fax Number : 606-633-1874
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MR. L.M. (MIKE) CAUDILL
Credential :
Telephone Number : 606-633-4823
Provider Enumeration Date : 05/19/2006
Last Update Date : 10/07/2024

Similar Medicare Providers

1730182817 — MS. AMY NORA ASHER WILSON APRN
Practice Location Address:
226 MEDICAL PLAZA LN
WHITESBURG, KY
41858-7425
Practice Phone: 606-633-4871
Practice Fax:
1174589659 — DR. SALAHADIN M GHARAD MD
Practice Location Address:
226 MEDICAL PLAZA LN , SUITE C
WHITESBURG, KY
41858-7425
Practice Phone: 606-633-2273
Practice Fax: 606-633-6204
1205880630 — MELISSA NEWELL CNM
Practice Location Address:
226 MEDICAL PLAZA LN
WHITESBURG, KY
41858-7425
Practice Phone: 606-633-4871
Practice Fax: 606-633-0883
1013962778 — NATHAN W BAKER MD
Practice Location Address:
226 MEDICAL PLAZA LN
WHITESBURG, KY
41858-7425
Practice Phone: 606-633-4871
Practice Fax: 606-633-0883
1710932488 — SARAH M JUSTICE PAC
Practice Location Address:
226 MEDICAL PLAZA LN
WHITESBURG, KY
41858-7425
Practice Phone: 606-633-4871
Practice Fax:
1033166350 — MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Practice Location Address:
226 MEDICAL PLAZA LN
WHITESBURG, KY
41858-7425
Practice Phone: 606-633-4871
Practice Fax: 606-633-1874

Directions to “MOUNTAIN COMPREHENSIVE HEALTH CORPORATION ” Practice Location

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