| Mountain Comprehensive Health Corporation | |
|
11313 Highland Ave Pound VA 24279-4145 | |
| (276) 796-8100 | |
| Not Available |
| Full Name | Mountain Comprehensive Health Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 11313 Highland Ave, Pound, Virginia |
| 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 |
|---|---|
| Mountain Comprehensive Health Corporation Po Box 40 Whitesburg KY 41858-0040 Ph: (606) 633-4823 | Mountain Comprehensive Health Corporation 11313 Highland Ave Pound VA 24279-4145 Ph: (276) 796-8100 |
| NPI Number | 1366201246 |
|---|---|
| Provider Enumeration Date | 03/14/2024 |
| Last Update Date | 04/15/2024 |
| Medicare PECOS PAC ID | 7618875873 |
|---|---|
| Medicare Enrollment ID | O20240517000820 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366201246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Kyla Stanley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396218988 PECOS PAC ID: 8628317674 Enrollment ID: I20240517000865 |
| Provider Name | Mary Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710319306 PECOS PAC ID: 6002125952 Enrollment ID: I20241023000890 |
| Provider Name | Devin Whitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821627068 PECOS PAC ID: 7012347784 Enrollment ID: I20250321001860 |
Experienced Care Clinic Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8008 Main St, Pound, VA 24279 Phone: 276-796-4586 |