Organization
JUNIPER HEALTH INC
Active
Parent organization
JUNIPER HEALTH INC
Other names
Juniper Health Breathitt High School
Organization subpart
Yes
Provider details
NPI number
Legal business name
JUNIPER HEALTH INC
Authorized official
DERRICK J HAMILTON DO (CEO)
(606) 666-9950
Entity
Organization
Contact information
Practice address
2307 BOBCAT LN, JACKSON, KY 41339-1160
(606) 464-0151
(606) 464-0152
Mailing address
PO BOX 690, BEATTYVILLE, KY 41311-0690
(606) 464-0151
(606) 464-0152
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31000862
—
KY
Enumeration date
09/27/2023
Last updated
09/27/2023
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