Provider Demographics
NPI:1245272707
Name:B-K HEALTH CENTER, INC
Entity type:Organization
Organization Name:B-K HEALTH CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLLERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-278-5157
Mailing Address - Street 1:498 S MAIN ST STE D
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:PA
Mailing Address - Zip Code:18801-1317
Mailing Address - Country:US
Mailing Address - Phone:570-278-7500
Mailing Address - Fax:570-278-0707
Practice Address - Street 1:25066 STATE ROUTE 11
Practice Address - Street 2:MOUNTAIN VIEW PLZ
Practice Address - City:HALLSTEAD
Practice Address - State:PA
Practice Address - Zip Code:18822-9511
Practice Address - Country:US
Practice Address - Phone:570-879-5249
Practice Address - Fax:570-278-0707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007701310006Medicaid
PA391863Medicare PIN
PA1007701310006Medicaid