Healthcare Provider Details

I. General information

NPI: 1982747804
Provider Name (Legal Business Name): PURCHASE DISTRICT HEALTH DEPT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 MCMORRIS ST
CLINTON KY
42031-1244
US

IV. Provider business mailing address

PO BOX 2357
PADUCAH KY
42002-2357
US

V. Phone/Fax

Practice location:
  • Phone: 270-653-4067
  • Fax:
Mailing address:
  • Phone: 270-444-9625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MISS STEPHANIE JO HAYS
Title or Position: FINANCE ADMINISTRATOR
Credential:
Phone: 270-444-9625