Healthcare Provider Details

I. General information

NPI: 1427000454
Provider Name (Legal Business Name): PURCHASE DISTRICT HEALTH DEPT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 04/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 BROWDER STREET
FULTON KY
42041
US

IV. Provider business mailing address

PO BOX 2357
PADUCAH KY
42002
US

V. Phone/Fax

Practice location:
  • Phone: 270-472-1982
  • Fax: 270-472-2553
Mailing address:
  • Phone: 270-444-9625
  • Fax: 270-575-5459

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: RONALD K. KOSTER
Title or Position: PUBLIC HEALTH DIRECTOR
Credential:
Phone: 270-444-9625