| Mountain Comprehensive Care Center, Inc. | |
|
129 Fraley Plz Grayson KY 41143-1274 | |
| (606) 886-8572 | |
| (606) 886-4433 |
| Full Name | Mountain Comprehensive Care Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 129 Fraley Plz, Grayson, Kentucky |
| Authorized Official Name and Position | Roxann Cordial (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 6068868572 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Comprehensive Care Center, Inc. 129 Fraley Plz Grayson KY 41143-1274 Ph: (606) 886-8572 | Mountain Comprehensive Care Center, Inc. 129 Fraley Plz Grayson KY 41143-1274 Ph: (606) 886-8572 |
| NPI Number | 1518441260 |
|---|---|
| Provider Enumeration Date | 09/19/2018 |
| Last Update Date | 10/06/2023 |
| Medicare PECOS PAC ID | 5294720553 |
|---|---|
| Medicare Enrollment ID | O20191003003181 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518441260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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