Healthcare Provider Details

I. General information

NPI: 1861531196
Provider Name (Legal Business Name): BRACKEN COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 FRANKFORT STREET
BROOKSVILLE KY
41004
US

IV. Provider business mailing address

429 FRANKFORT STREET
BROOKSVILLE KY
41004
US

V. Phone/Fax

Practice location:
  • Phone: 606-735-2157
  • Fax: 606-735-2159
Mailing address:
  • Phone: 606-735-2157
  • Fax: 606-735-2159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number251K0000X
License Number StateKY

VIII. Authorized Official

Name: TONY ANDERSON COX
Title or Position: ADMINISTRATOR
Credential:
Phone: 606-735-2157