MEDICARE: GREEN RIVER DISTRICT HEALTH DEPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053385252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREEN RIVER DISTRICT HEALTH DEPT

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

Provider Business Practice Location Address
First Line	:	1336 CLAY ST
Second Line	:	OHIO COUNTY HEALTH CENTER
City	:	HARTFORD
State	:	KY
Zip	:	42347-1637
Country	:	US
Telephone Number	:	270-298-3663
Fax Number	:	270-298-4777

Authorized Official
Title or Position	:	ADMINISTRATIVE SERVICES MANAGER
Name	:	MRS. ANGEL THOMPSON
Credential	:	M.S.M.
Telephone Number	:	270-686-7747

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	10/18/2024

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