Organization
JUNIPER HEALTH, INC
Active
Parent organization
JUNIPER HEALTH, INC.
Other names
JHI Wolfe County Family Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
JUNIPER HEALTH, INC.
Authorized official
MRS. KAREN S DITSCH (CEO)
(606) 464-0151
Entity
Organization
Contact information
Practice address
202 PLUMMER STREET, CAMPTON, KY 41301-7879
(606) 668-7385
(606) 668-7009
Mailing address
PO BOX 690, BEATTYVILLE, KY 41311-0690
(606) 464-0151
(606) 464-0152
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
700132A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
181919
MEDICARE FQHC PTAN
KY
05
—
31000862
—
KY
01
—
9521
MEDICARE PART B
KY
Enumeration date
01/03/2014
Last updated
01/15/2020
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