Organization
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
L.M. (MIKE) CAUDILL (CEO)
(606) 633-4823
Entity
Organization
Contact information
Practice address
366 PARKS ST, WHITESBURG, KY 41858-7539
(606) 633-4823
Mailing address
PO BOX 40, WHITESBURG, KY 41858-0040
(606) 633-4823
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
08/17/2012
Last updated
10/07/2024
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