1831196013 NPI number — COUNTY OF BALLARD FISCAL COURT

Table of content: (NPI 1831196013)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831196013 NPI number — COUNTY OF BALLARD FISCAL COURT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF BALLARD 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:
1831196013
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 276
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WICKLIFFE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42087-0276
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-665-5000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 BROADWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA CENTER
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42056-9998
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-665-9328
Provider Business Practice Location Address Fax Number:
270-665-5083
Provider Enumeration Date:
07/04/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ARMSTRONG
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
BECKY
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
270-665-5000

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  1501 , 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: 000000232102 . This is a "ANTHEM BLUE CROSS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 56003478 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 406590892 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 605804900 . This is a "US DEPARTMENT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 623460 . This is a "WELLCARE - MEDICAID MCO" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 55004014 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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