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
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