Organization
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
L,M. CAUDILL (CHIEF EXECUTIVE OFFICER)
(606) 633-4823
Entity
Organization
Contact information
Practice address
1620 E MAIN ST, CUMBERLAND, KY 40823-1837
(606) 589-6113
(606) 589-4436
Mailing address
PO BOX 40, WHITESBURG, KY 41858-0040
(606) 633-4823
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
700017
KY
207Q00000X
Family Medicine Physician
700017
KY
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
700017
KY
Other
Enumeration date
08/29/2016
Last updated
10/07/2024
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