| Proctorville Health Care Center | |
|
10777 County Road 107 Proctorville OH 45669-8130 | |
| (740) 302-0541 | |
| (740) 886-0255 |
| Full Name | Proctorville Health Care Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 10777 County Road 107, Proctorville, Ohio |
| Authorized Official Name and Position | Nancy Lewis (DIRECTOR OF HEALTH SERVICES) |
| Authorized Official Contact | 7405323534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Proctorville Health Care Center 305 N 5th St Ironton OH 45638-1578 Ph: (740) 532-3534 | Proctorville Health Care Center 10777 County Road 107 Proctorville OH 45669-8130 Ph: (740) 302-0541 |
| NPI Number | 1912254574 |
|---|---|
| Provider Enumeration Date | 08/13/2012 |
| Last Update Date | 01/03/2014 |
| Medicare PECOS PAC ID | 8820902497 |
|---|---|
| Medicare Enrollment ID | O20121127000032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912254574 | NPI | - | NPPES |
| 0078529 | Medicaid | OH | |
| 3810026147 | Medicaid | WV | |
| 7100249710 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Legacy Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 148 State Route 775, Proctorville, OH 45669 Phone: 740-886-7000 Fax: 740-886-5518 | |
Proctorville Health Care Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10777 County Road 107, Proctorville, OH 45669 Phone: 740-302-0541 Fax: 740-886-0255 |