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NPI Code Detail

MEDICARE: TODD COUNTY CENTRAL HIGH SCHOOL CLINIC

MEDICARE: TODD COUNTY CENTRAL HIGH SCHOOL CLINIC
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
1251K00000XPublic Health or Welfare Agency

Other Identifiers

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

General Provider Information

NPI Number : 1528395100
Entity Type Code : Organization
Provider Name (Legal Business Name) : TODD COUNTY CENTRAL HIGH SCHOOL CLINIC
Provider Business Mailing Address
First Line : PO BOX 305
Second Line :
City : ELKTON
State : KY
Zip : 42220-0305
Country : US
Telephone Number : 270-265-2362
Fax Number : 270-265-0602
Provider Business Practice Location Address
First Line : 806 S MAIN ST
Second Line :
City : ELKTON
State : KY
Zip : 42220-8812
Country : US
Telephone Number : 270-265-2362
Fax Number : 270-265-0602
Authorized Official
Title or Position : ADM. SPEC. II
Name : MRS. SHEILA GRIGGS
Credential :
Telephone Number : 270-265-2362
Provider Enumeration Date : 11/03/2009
Last Update Date : 11/04/2009

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Practice Location Address:
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42220-8812
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1447389895 — GUADALUPE ROBLES MISQUEZ N.P.
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1962618033 — HOLLY ANNETTE GROVES APRN, FNP-C, RD, LD
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Practice Fax:
1144616491 — DR. MALLORY C. JORIF M.D.
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42220-8812
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1609307743 — LORISSA A DIAS APRN
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1023532397 — MRS. JENNIFER LYNNE HENDERSON FNP
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Directions to “TODD COUNTY CENTRAL HIGH SCHOOL CLINIC ” Practice Location

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