Provider Demographics
NPI:1952801037
Name:B-K HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:B-K HEALTH CENTER, INC.
Other - Org Name:NEPA COMMUNITY HEALTH CARE
Other - Org Type:Doing Business As
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:
Practice Address - Street 1:127 ROUTE 106
Practice Address - Street 2:
Practice Address - City:GREENFIELD TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18407-3526
Practice Address - Country:US
Practice Address - Phone:570-278-7500
Practice Address - Fax:570-278-0707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-15
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
PA1007701310047Medicaid