Organization
FEDERAL CORRECTIONAL INSITUTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGEL WILSON HSA (HEALTH SERVICES ADMINISTRATOR)
(606) 598-1900
Entity
Organization
Contact information
Practice address
805 FOX HOLLOW RD, MANCHESTER, KY 40962-7923
(606) 598-1900
(606) 599-4196
Mailing address
805 FOX HOLLOW RD, MANCHESTER, KY 40962-7923
(606) 598-1900
(606) 599-4196
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
10/09/2015
Last updated
10/09/2015
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