Healthcare Provider Details

I. General information

NPI: 1104008358
Provider Name (Legal Business Name): MADISON COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 NORTH SECOND ST.
RICHMOND KY
40475
US

IV. Provider business mailing address

216 BOGGS LANE
RICHMOND KY
40475-2522
US

V. Phone/Fax

Practice location:
  • Phone: 859-624-4530
  • Fax:
Mailing address:
  • Phone: 859-623-7312
  • Fax:

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: NANCY M CREWE
Title or Position: DIRECTOR
Credential:
Phone: 859-626-4241