Organization
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. L.M. (MIKE) CAUDILL (CHIEF EXECUTIVE OFFICER)
(606) 633-4823
Entity
Organization
Contact information
Practice address
72 BUCKHORN CLINIC RD, BUCKHORN, KY 41721-8936
(606) 398-7141
(606) 398-7136
Mailing address
PO BOX 40, WHITESBURG, KY 41858-0040
(606) 633-4823
(606) 633-1874
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31000169
—
KY
Enumeration date
05/19/2006
Last updated
10/07/2024
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