EASTERN KENTUCKY TENDER CARE PEDIATRICS LLC NPI 1043437254

NPI Information

NPI: 1043437254
Provider Name: EASTERN KENTUCKY TENDER CARE PEDIATRICS LLC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
400 UNIVERSITY DR STE 101
PRESTONSBURG, KY
ZIP 41653
Phone: (606) 886-1173
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EASTERN KENTUCKY TENDER CARE PEDIATRICS LLC is a rural health clinic center in Prestonsburg, KY. EASTERN KENTUCKY TENDER CARE PEDIATRICS LLC NPI is 1043437254. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

400 UNIVERSITY DR STE 101
PRESTONSBURG, KY
ZIP 41653-080
Phone: (606) 886-1173
Fax: (606) 886-2193

The provider's authorized official is Antoin Hana .
The authorized official title is Owner and has the following contact phone number (606) 886-1173.

The enumeration date for this NPI number is 4/19/2007 and was last updated on 2/24/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics				No
2	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7100006320	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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