Healthcare Provider Details

I. General information

NPI: 1285631259
Provider Name (Legal Business Name): DEK HEALTH ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 NEWCOMB AVE
MOUNT VERNON KY
40456-2732
US

IV. Provider business mailing address

PO BOX 929
MOUNT VERNON KY
40456-0929
US

V. Phone/Fax

Practice location:
  • Phone: 606-256-4013
  • Fax: 606-256-1242
Mailing address:
  • Phone: 606-256-4013
  • Fax: 606-256-1242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. REBECCA GIRDLER
Title or Position: MANAGER
Credential:
Phone: 606-256-4013