MEDICARE: BULLITT COUNTY HEALTH DEPARTMENT

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		KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	87212	OTHER	KY	COVENTRY CARES OF KY
2	1051411	OTHER		PASSPORT HEALTH PLAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	645482	OTHER	KY	WELLCARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811997661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BULLITT COUNTY HEALTH DEPARTMENT

Provider Business Mailing Address
First Line	:	181 LEES VALLEY RD
Second Line	:
City	:	SHEPHERDSVILLE
State	:	KY
Zip	:	40165-6143
Country	:	US
Telephone Number	:	502-955-7837
Fax Number	:	502-543-2998

Provider Business Practice Location Address
First Line	:	181 LEES VALLEY RD
Second Line	:
City	:	SHEPHERDSVILLE
State	:	KY
Zip	:	40165-6143
Country	:	US
Telephone Number	:	502-955-7837
Fax Number	:	502-543-2998

Authorized Official
Title or Position	:	PUBLIC HEALTH DIRECTOR
Name	:	MRS. ANDREA D RENFROW
Credential	:	MSN, RN
Telephone Number	:	502-955-6680

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	07/21/2022

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Directions to “BULLITT COUNTY HEALTH DEPARTMENT ” Practice Location

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