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NPI Code Detail

MEDICARE: PINEVILLE COMMUNITY HOSPITAL ASSN INC.

MEDICARE: PINEVILLE COMMUNITY HOSPITAL ASSN INC.
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
1282N00000XGeneral Acute Care Hospital

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000000206420OTHERKYANTHEM BCBS ANES GROUP

General Provider Information

NPI Number : 1821085440
Entity Type Code : Organization
Provider Name (Legal Business Name) : PINEVILLE COMMUNITY HOSPITAL ASSN INC.
Provider Business Mailing Address
First Line : 850 RIVERVIEW RD
Second Line :
City : PINEVILLE
State : KY
Zip : 40977-1430
Country : US
Telephone Number : 606-337-3051
Fax Number : 606-337-2871
Provider Business Practice Location Address
First Line : 850 RIVERVIEW RD
Second Line :
City : PINEVILLE
State : KY
Zip : 40977-1430
Country : US
Telephone Number : 606-337-3051
Fax Number : 606-337-2871
Authorized Official
Title or Position : CONTROLLER
Name : MR. KEVIN COUCH
Credential :
Telephone Number : 606-337-3051
Provider Enumeration Date : 09/29/2005
Last Update Date : 04/20/2018

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1447272216 — PINEVILLE COMMUNITY HOSPITAL ASSOCIATION, INC.
Practice Location Address:
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40977-1430
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Practice Fax: 606-337-2871

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