Organization
PIKEVILLE MEDICAL BUILDING LAB., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN K HALL BSMT(ASCP) (OWNER-OPERATOR)
(606) 432-1266
Entity
Organization
Contact information
Practice address
387 TOWN MOUNTAIN RD, SUITE 203, PIKEVILLE, KY 41501-1640
(606) 432-1266
(606) 432-1944
Mailing address
PO BOX 2529, PIKEVILLE, KY 41502-2529
(606) 432-1266
(606) 432-1944
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
200148
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000190221
BC-BS PROVIDER NUMVER
KY
05
—
37000197
—
KY
01
—
4004601-5801
COMMERCIAL CLAIM PROVIDER
—
Enumeration date
12/14/2006
Last updated
08/22/2020
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