Breathitt County Family Health Center
LBN: Juniper Health Inc
Breathitt County Family Health Center is an health care organization with primary practice located at 1484 Lakeside Drive , Jackson KY 41339-7370. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty.
Juniper Health Inc can be contacted via phone (606) 666-9950, or through Hamilton, Derrick J via phone (606) 666-9950.
Contact Information
Primary practice address
1484 Lakeside Drive
Jackson KY 41339-7370
Phone: (606) 666-9950
Fax: (606) 666-9136
Website:
Authorized official contact:
Name: Hamilton, Derrick J Doctor of Osteopathy (DO)
Phone: (606) 666-9950
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | ||
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X | 700140 | Kentucky |
Profile Details
| NPI number | 1467417691 |
|---|---|
| LBN Legal business name | Juniper Health Inc |
| DBA Doing business as | Breathitt County Family Health Center |
| Authorized official | Hamilton, Derrick J Doctor of Osteopathy (DO) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Apr 19th, 2006 |
| Last updated | Jul 14th, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467417691 | NPPES |
| Kentucky | Other | 181853 | MEDICARE FQHC PTAN |
| Kentucky | MEDICAID | 31000854 | MEDICARE FQHC PTAN |
| Kentucky | Other | 9521 | MEDICARE FQHC PTAN |
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