Clover Fork Outpatient Medical Project INC

NPI #1497195036 in Harlan, Kentucky

Provider Information

NPI Number: 1497195036
Entity Type: Organization
Organization Name: Clover Fork Outpatient Medical Project INC
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: Jun 27, 2013
Last Updated: Nov 20, 2018

Practice Location

Address: 209 E MOUND ST
City: Harlan
State: Kentucky
ZIP Code: 40831-2321
Phone: (606) 573-1975

Authorized Official

Name: MR. BRITT LEWIS JR.
Title: ADMINISTRATOR
Phone: (606) 837-2108

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rural Health — Rural Health	261QR1300X
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X	Primary

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