Healthcare Provider Details

I. General information

NPI: 1194704999
Provider Name (Legal Business Name): HENDERSON COUNTY HEALTH CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 01/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 KIMSEY LN
HENDERSON KY
42420-2665
US

IV. Provider business mailing address

851 KIMSEY LN
HENDERSON KY
42420-2665
US

V. Phone/Fax

Practice location:
  • Phone: 270-826-6436
  • Fax: 270-826-7953
Mailing address:
  • Phone: 270-826-6436
  • Fax: 270-826-7953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number100423
License Number StateKY

VIII. Authorized Official

Name: MR. MARK CHUMBLER
Title or Position: ADMINISTRATOR
Credential:
Phone: 270-826-6436