Healthcare Provider Details

I. General information

NPI: 1316382146
Provider Name (Legal Business Name): HARLAN COUNTY HEALTH DEPARTMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 E CLOVER ST
HARLAN KY
40831-2312
US

IV. Provider business mailing address

402 E CLOVER ST
HARLAN KY
40831-2312
US

V. Phone/Fax

Practice location:
  • Phone: 606-573-3700
  • Fax: 606-573-6128
Mailing address:
  • Phone: 606-573-3700
  • Fax: 606-573-6128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number3004105
License Number StateKY

VIII. Authorized Official

Name: MS. BOBBIE V CRIDER
Title or Position: INTERIM DIRECTOR
Credential: R.N.
Phone: 606-573-3700