Healthcare Provider Details

I. General information

NPI: 1073843082
Provider Name (Legal Business Name): OLDHAM COUNTY BOARD OF EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2010
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6165 W. HIGHWAY 146
BUCKNER KY
40010
US

IV. Provider business mailing address

6165 W. HIGHWAY 146
BUCKNER KY
40010
US

V. Phone/Fax

Practice location:
  • Phone: 502-222-8880
  • Fax: 502-222-8885
Mailing address:
  • Phone: 502-222-8880
  • Fax: 502-222-8885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateKY

VIII. Authorized Official

Name: MS. JUDY MALLORY
Title or Position: DOSE
Credential:
Phone: 502-222-8880