Healthcare Provider Details
I. General information
NPI: 1659554129
Provider Name (Legal Business Name): MADISON COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/07/2007
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
705 N 2ND ST
RICHMOND KY
40475-1259
US
IV. Provider business mailing address
216 BOGGS LN
RICHMOND KY
40475-2522
US
V. Phone/Fax
- Phone: 859-624-4505
- Fax:
- Phone: 859-623-7312
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public 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