| Mobile Health Clinic | |
|
1540 Us Highway 25 E Middlesboro KY 40965-1861 | |
| (606) 654-9450 | |
| Not Available |
| Full Name | Mobile Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1540 Us Highway 25 E, Middlesboro, Kentucky |
| Authorized Official Name and Position | Delena P Miller (CREDENTIALING) |
| Authorized Official Contact | 6066334823 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Health Clinic Po Box 40 Whitesburg KY 41858-0040 Ph: (606) 633-4823 | Mobile Health Clinic 1540 Us Highway 25 E Middlesboro KY 40965-1861 Ph: (606) 654-9450 |
| NPI Number | 1063913788 |
|---|---|
| Provider Enumeration Date | 02/27/2018 |
| Last Update Date | 03/06/2024 |
| Medicare PECOS PAC ID | 7618875873 |
|---|---|
| Medicare Enrollment ID | O20180315001335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063913788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 700017 (Kentucky) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
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