| Pikeville Medical Center Inc | |
|
2255 Spruce Goose St Unit 518 Las Vegas NV 89135-2647 | |
| (606) 430-3500 | |
| Not Available |
| Full Name | Pikeville Medical Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2255 Spruce Goose St Unit 518, Las Vegas, Nevada |
| Authorized Official Name and Position | Michelle Hagy (CFO) |
| Authorized Official Contact | 6064303519 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pikeville Medical Center Inc Po Box 432 Pikeville KY 41502-0432 Ph: (606) 430-3500 | Pikeville Medical Center Inc 2255 Spruce Goose St Unit 518 Las Vegas NV 89135-2647 Ph: (606) 430-3500 |
| NPI Number | 1407608458 |
|---|---|
| Provider Enumeration Date | 04/03/2024 |
| Last Update Date | 04/03/2024 |
| Medicare PECOS PAC ID | 6709790157 |
|---|---|
| Medicare Enrollment ID | O20240524002838 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407608458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | James Wang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003203902 PECOS PAC ID: 0446571574 Enrollment ID: I20240429001521 |
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