EASTERN KY TENDER CARE PEDIATRICS LLC NPI 1831190115

NPI Information

NPI: 1831190115
Provider Name: EASTERN KY TENDER CARE PEDIATRICS, LLC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
5000 KY ROUTE 321
SUITE 3141
PRESTONSBURG, KY
ZIP 41653
Phone: (606) 886-7517
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EASTERN KY TENDER CARE PEDIATRICS, LLC is a rural health clinic center in Prestonsburg, KY. EASTERN KY TENDER CARE PEDIATRICS, LLC NPI is 1831190115. The provider is registered as an organization entity type.

The provider's business location address is:

5000 KY ROUTE 321
SUITE 3141
PRESTONSBURG, KY
ZIP 41653-113
Phone: (606) 886-7517
Fax: (606) 886-7524

The provider's authorized official is Antoin Hana .
The authorized official title is Owner and has the following contact phone number (606) 886-7517.

The enumeration date for this NPI number is 8/9/2005 and was last updated on 8/22/2020.

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	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	000000260816	OTHER	KENTUCKY	ANTHEM BCBS

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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