Provider Demographics
NPI:1861628265
Name:PIKEVILLE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:PIKEVILLE MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-218-3500
Mailing Address - Street 1:PO BOX 2917
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-2917
Mailing Address - Country:US
Mailing Address - Phone:606-218-3500
Mailing Address - Fax:606-218-4562
Practice Address - Street 1:1535 SLATE CREEK ROAD
Practice Address - Street 2:
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614-1535
Practice Address - Country:US
Practice Address - Phone:606-218-3500
Practice Address - Fax:606-218-4562
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIKEVILLE MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-01
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0136Medicare PIN
VAC10805Medicare PIN