Provider Demographics
NPI:1922594506
Name:BIG SANDY HEALTH CARE INC
Entity Type:Organization
Organization Name:BIG SANDY HEALTH CARE INC
Other - Org Name:HOPE FAMILY HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BOYCE
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:SHOFNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-886-8546
Mailing Address - Street 1:214 BERIAH BLVD
Mailing Address - Street 2:
Mailing Address - City:SALYERSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41465
Mailing Address - Country:US
Mailing Address - Phone:606-349-5126
Mailing Address - Fax:606-349-5123
Practice Address - Street 1:214 BERIAH BLVD
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465
Practice Address - Country:US
Practice Address - Phone:606-349-5126
Practice Address - Fax:606-349-5123
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIG SANDY HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-06
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY700015261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)