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DSH180154 PINEVILLE COMMUNITY HEALTH CENTER, Inc. (Active)
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Main Details
Name
PINEVILLE COMMUNITY HEALTH CENTER, Inc.
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH180154
Medicare Provider Number
180154
Additional Details
Current Program Status
Active
Registration Date
6/23/2021
Participating Start Date
7/26/2021
Participating Approval Date
7/14/2021
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
Pineville Community Health Center
Michael Frey, CEO
(606) 337-3051
Primary Contact
Pineville Community Health Center
James Baxter Brown, Primary Contact
(606) 875-0518
Addresses
Street Address
850 RIVERVIEW AVENUE
PINEVILLE, KY 40977
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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