Healthcare Provider Details

I. General information

NPI: 1437295854
Provider Name (Legal Business Name): MADISON COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 BOGGS LANE
RICHMOND KY
40476
US

IV. Provider business mailing address

216 BOGGS LANE P.O. BOX 1208
RICHMOND KY
40476
US

V. Phone/Fax

Practice location:
  • Phone: 859-626-4509
  • Fax: 859-624-1024
Mailing address:
  • Phone: 859-626-4509
  • Fax: 859-624-1024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. BILLIE DYER
Title or Position: NURSING ADMINISTRATOR
Credential: RN
Phone: 859-626-4509