Organization
PRIMARY CARE CENTERS OF EASTERN KENTUCKY, LLC
Active
Other names
Primary Care Centers of Eastern Kentucky-Vicco
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY K MARTIN (CEO)
(606) 439-1300
Entity
Organization
Contact information
Practice address
10616 S KY HWY 15, SUITE A, SCUDDY, KY 41760-9033
(606) 476-2274
(606) 476-2304
Mailing address
PO BOX 1988, SUITE B, HAZARD, KY 41702-1988
(606) 439-1300
(606) 439-1400
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000560892
BC/BS
KY
05
—
35002039
—
KY
Enumeration date
05/16/2006
Last updated
05/26/2023
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