1457512311 NPI number — PENNYRILE DISTRICT LHEALTH DEPARTMENT

Table of content: (NPI 1457512311)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457512311 NPI number — PENNYRILE DISTRICT LHEALTH DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PENNYRILE DISTRICT LHEALTH 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:
Provider Other Organization Name Type Code:
6
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:
1457512311
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 770
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDDYVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42038-0770
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-388-9747
Provider Business Mailing Address Fax Number:
270-388-7749

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 MARION RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42445-6210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-388-9747
Provider Business Practice Location Address Fax Number:
270-388-7749
Provider Enumeration Date:
06/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
BESHEAR
Authorized Official First Name:
ALLISON
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PUBLIC HEALTH DIRECTOR
Authorized Official Telephone Number:
270-388-9747

Provider Taxonomy Codes

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

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

  • Identifier: 7100044740 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com