Provider Demographics
NPI:1609064468
Name:COMMUNITY HEALTH CARE, LLC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:606-886-0805
Mailing Address - Street 1:126 TRIVETTE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1275
Mailing Address - Country:US
Mailing Address - Phone:606-432-0051
Mailing Address - Fax:606-437-9540
Practice Address - Street 1:60 LAUREL RDG
Practice Address - Street 2:CEDAR TRACE
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-8378
Practice Address - Country:US
Practice Address - Phone:606-886-0805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2675P261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
00470001Medicare PIN