Organization
PINEVILLE COMMUNITY HOSPITAL ASSN INC
Active
Organization
PINEVILLE COMMUNITY HOSPITAL ASSN INC
Active
Other names
PCH MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW BROCK (CEO)
(606) 337-3051
Entity
Organization
Contact information
Practice address
850 RIVERVIEW AVE, PINEVILLE, KY 40977-1430
(606) 337-3051
(606) 337-2871
Mailing address
850 RIVERVIEW AVE, PINEVILLE, KY 40977-1430
(606) 337-3051
(606) 337-2871
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
100020
KY
363LF0000X
Family Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01011352
—
KY
01
—
180021
MEDICARE ID
KY
Enumeration date
04/04/2008
Last updated
09/21/2017
Update your record
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