| Primary Care Centers Of Eastern Kentucky, Llc | |
|
10616 S Ky Hwy 15 Suite A Scuddy KY 41760-9033 | |
| (606) 476-2274 | |
| (606) 476-2304 |
| Full Name | Primary Care Centers Of Eastern Kentucky, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10616 S Ky Hwy 15, Scuddy, Kentucky |
| Authorized Official Name and Position | Barry K Martin (CEO) |
| Authorized Official Contact | 6064391300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Centers Of Eastern Kentucky, Llc Po Box 1988 Suite B Hazard KY 41702-1988 Ph: (606) 439-1300 | Primary Care Centers Of Eastern Kentucky, Llc 10616 S Ky Hwy 15 Suite A Scuddy KY 41760-9033 Ph: (606) 476-2274 |
| NPI Number | 1184676314 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 05/26/2023 |
| Medicare PECOS PAC ID | 3971415993 |
|---|---|
| Medicare Enrollment ID | O20210108000736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184676314 | NPI | - | NPPES |
| 000000560892 | Other | KY | BC/BS |
| 35002039 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |