Organization
JUNIPER HEALTH INC
Active
Parent organization
JUNIPER HEALTH INC
Other names
Lee County Family Medical Clinic, Lee County Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
JUNIPER HEALTH INC
Authorized official
DERRICK J HAMILTON DO, CEO, CMO (CEO)
(606) 666-9950
Entity
Organization
Contact information
Practice address
1025 GRAND AVENUE, BEATTYVILLE, KY 41311-9249
(606) 464-2401
(606) 464-3290
Mailing address
PO BOX 690, BEATTYVILLE, KY 41311-0690
(606) 464-0151
(606) 464-1052
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
700132
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
181848
MEDCIARE FQHC PTAN
KY
05
—
31000862
—
KY
01
—
9521
MEDICARE PART B
KY
Enumeration date
04/04/2006
Last updated
05/12/2025
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