1912976069 NPI number — CHRISTIAN COUNTY HEALTH DEPARTMENT

Table of content: (NPI 1912976069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912976069 NPI number — CHRISTIAN COUNTY HEALTH DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRISTIAN COUNTY 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:
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:
1912976069
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1700 CANTON ST
Provider Second Line Business Mailing Address:
POST OFFICE BOX 647
Provider Business Mailing Address City Name:
HOPKINSVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42240-1923
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-887-4160
Provider Business Mailing Address Fax Number:
270-886-6192

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 CANTON ST
Provider Second Line Business Practice Location Address:
POST OFFICE BOX 647
Provider Business Practice Location Address City Name:
HOPKINSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42240-1923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-887-4160
Provider Business Practice Location Address Fax Number:
270-886-6192
Provider Enumeration Date:
03/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STALLONS
Authorized Official First Name:
RITA
Authorized Official Middle Name:
Authorized Official Title or Position:
ACCOUNT CLERK II
Authorized Official Telephone Number:
270-887-4160

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: 15000029 . This is a "HANDS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 20024014 . This is a "MEDICAID" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000072598 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 2110 . This is a "GROUP NUMBER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: P00038381 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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