Healthcare Provider Details

I. General information

NPI: 1457458861
Provider Name (Legal Business Name): GREEN RIVER DISTRICT HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 BRECKENRIDGE ST
OWENSBORO KY
42303-1054
US

IV. Provider business mailing address

1501 BRECKENRIDGE ST
OWENSBORO KY
42303-1054
US

V. Phone/Fax

Practice location:
  • Phone: 270-686-7747
  • Fax: 270-926-9862
Mailing address:
  • Phone: 270-686-7747
  • Fax: 270-926-9862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARION LEE DENHAM
Title or Position: PUBLIC HEALTH DIRECTOR
Credential:
Phone: 270-686-7747