Provider Demographics
NPI:1881370518
Name:MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Entity type:Organization
Organization Name:MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER INSURANCE CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:DELENA
Authorized Official - Middle Name:P
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-633-4823
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:WHITESBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41858-0040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:396 HIGHWAY 899
Practice Address - Street 2:
Practice Address - City:HINDMAN
Practice Address - State:KY
Practice Address - Zip Code:41822-8953
Practice Address - Country:US
Practice Address - Phone:606-785-0208
Practice Address - Fax:606-785-0209
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-27
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy