Healthcare Provider Details

I. General information

NPI: 1154528537
Provider Name (Legal Business Name): WHITLEY COUNTY HEALTH DEPTARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 04/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 FALLS HWY.
CORBIN KY
40701
US

IV. Provider business mailing address

PO BOX 1221
CORBIN KY
40702-1221
US

V. Phone/Fax

Practice location:
  • Phone: 606-528-5613
  • Fax:
Mailing address:
  • Phone: 606-528-5613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. CHERYL L PARKS
Title or Position: ACCOUNT CLERK III
Credential:
Phone: 606-549-3380