| Pine Mountain Clinic Psc | |
|
850 Riverview Rd Pineville KY 40977-1430 | |
| (606) 337-6047 | |
| (606) 337-0925 |
| Full Name | Pine Mountain Clinic Psc |
|---|---|
| Speciality | Internal Medicine |
| Location | 850 Riverview Rd, Pineville, Kentucky |
| Authorized Official Name and Position | Madhan Mohan (OWNER) |
| Authorized Official Contact | 6063376047 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Mountain Clinic Psc 850 Riverview Rd Po Box 308 Pineville KY 40977-1430 Ph: (606) 337-6047 | Pine Mountain Clinic Psc 850 Riverview Rd Pineville KY 40977-1430 Ph: (606) 337-6047 |
| NPI Number | 1205054327 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 11/24/2008 |
| Medicare PECOS PAC ID | 3476599580 |
|---|---|
| Medicare Enrollment ID | O20050629000386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205054327 | NPI | - | NPPES |
| 65930851 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 29667 (Kentucky) | Primary |
| Provider Name | Madhan Mohan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669482816 PECOS PAC ID: 8628085552 Enrollment ID: I20080125000199 |
| Provider Name | Eleanor Liford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528323672 PECOS PAC ID: 8325296718 Enrollment ID: I20120910000195 |
| Provider Name | Mary Catherine Caruso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760980882 PECOS PAC ID: 3870854425 Enrollment ID: I20180223000243 |
| Provider Name | Kendra Michelle Hurst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780156844 PECOS PAC ID: 3870839491 Enrollment ID: I20190117003038 |
| Provider Name | Whitney Jeree Gann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194371419 PECOS PAC ID: 3577893718 Enrollment ID: I20191001002002 |
| Provider Name | Makayla Jean Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154952844 PECOS PAC ID: 0244667582 Enrollment ID: I20200225002736 |
Southeast Family Practice Psc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 222 W Tennessee Ave, Pineville, KY 40977 Phone: 606-499-5135 | |
Pineville Community Hospital Association, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 W Virginia Ave, Pineville, KY 40977 Phone: 606-337-2381 | |
Total Care Rural Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 850 Riverview Ave, Pineville, KY 40977 Phone: 606-654-4775 Fax: 606-654-2613 | |
Memorial Hospital Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12904 Robert L Madon Byp Ste 2, Pineville, KY 40977 Phone: 606-598-4508 Fax: 606-712-1200 | |
Southeastern Ky Total Care Rhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 W Virginia Ave, Pineville, KY 40977 Phone: 606-337-3051 Fax: 606-337-2871 | |
Jerry L. Woolum, M.d., P.s.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 Virginia Avenue, Suite F200, Pineville, KY 40977 Phone: 606-337-0860 Fax: 606-337-9956 |