Provider Demographics
NPI:1275192924
Name:PINEVILLE COMMUNITY HEALTH CENTER INC
Entity Type:Organization
Organization Name:PINEVILLE COMMUNITY HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MSO
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-337-3051
Mailing Address - Street 1:850 RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40977-1452
Mailing Address - Country:US
Mailing Address - Phone:606-337-3051
Mailing Address - Fax:606-337-1128
Practice Address - Street 1:850 RIVERVIEW AVE
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:KY
Practice Address - Zip Code:40977-1452
Practice Address - Country:US
Practice Address - Phone:606-337-3051
Practice Address - Fax:606-337-1128
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PINEVILLE COMMUNITY HEALTH CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-06
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty