| Kentucky Mountain Health Alliance, Inc. | |
|
279 E Main St Hazard KY 41701-1920 | |
| (606) 487-9505 | |
| (606) 436-0071 |
| Full Name | Kentucky Mountain Health Alliance, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 279 E Main St, Hazard, Kentucky |
| Authorized Official Name and Position | Ellen Vance (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6064879505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentucky Mountain Health Alliance, Inc. 279 E Main St Ste 300 Hazard KY 41701-1920 Ph: (606) 487-9505 | Kentucky Mountain Health Alliance, Inc. 279 E Main St Hazard KY 41701-1920 Ph: (606) 487-9505 |
| NPI Number | 1407043979 |
|---|---|
| Provider Enumeration Date | 09/28/2007 |
| Last Update Date | 11/03/2023 |
| Medicare PECOS PAC ID | 8123112687 |
|---|---|
| Medicare Enrollment ID | O20070914000632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407043979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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