1417937822 NPI number — GREEN RIVER DISTRICT HEALTH DEPARTMENT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417937822 NPI number — GREEN RIVER DISTRICT HEALTH DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GREEN RIVER DISTRICT HEALTH DEPARTMENT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
UNION COUNTY HEALTH CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417937822
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 309
Provider Second Line Business Mailing Address:
GREEN RIVER DISTRICT HEALTH DEPARTMENT
Provider Business Mailing Address City Name:
OWENSBORO
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42302-0309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-686-7747
Provider Business Mailing Address Fax Number:
270-926-9862

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
218 WEST MCELROY
Provider Second Line Business Practice Location Address:
UNION COUNTY HEALTH CENTER
Provider Business Practice Location Address City Name:
MORGANFIELD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-389-1230
Provider Business Practice Location Address Fax Number:
270-389-9031
Provider Enumeration Date:
01/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
THOMPSON
Authorized Official First Name:
ANGEL
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATIVE SERVICES MANAGER
Authorized Official Telephone Number:
270-686-7747

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 20113015 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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