1467419283 NPI number — OWEN COUNTY FISCAL COURT

Table of content: (NPI 1467419283)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467419283 NPI number — OWEN COUNTY FISCAL COURT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OWEN COUNTY FISCAL COURT
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:
1467419283
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 NORTH THOMAS STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OWENTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40359
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-484-3405
Provider Business Mailing Address Fax Number:
502-484-1004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
208 EAST BLANTON STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OWENTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-484-5214
Provider Business Practice Location Address Fax Number:
502-484-3958
Provider Enumeration Date:
04/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WOODYARD
Authorized Official First Name:
RUSSELL
Authorized Official Middle Name:
T
Authorized Official Title or Position:
COUNTY EXECUTIVE
Authorized Official Telephone Number:
502-484-3405

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  1141 , 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: 000000070457 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 56004575NON-EMERGENC , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1080147 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1080147PASSPORTHEALT . This is a "PASSPORT HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 55094015EMERGENCY , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 55094015 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2435453000 . This is a "PASSPORT ADVANTAGE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 2435453000PASSPORTAD . This is a "PASSPORT ADVANTAGE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 56004575 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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