Provider Demographics
NPI:1922594506
Name:BIG SANDY HEALTH CARE INC
Entity type:Organization
Organization Name:BIG SANDY HEALTH CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HERALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-886-8546
Mailing Address - Street 1:1709 KY ROUTE 321 STE 3
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9097
Mailing Address - Country:US
Mailing Address - Phone:606-886-8546
Mailing Address - Fax:606-349-5123
Practice Address - Street 1:452 TOM FRAZIER WAY
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465-7704
Practice Address - Country:US
Practice Address - Phone:606-349-5126
Practice Address - Fax:888-338-9735
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIG SANDY HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-06
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY700015261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)