Healthcare Provider Details
I. General information
NPI: 1801930151
Provider Name (Legal Business Name): LAKE CUMBERLAND DISTRICT HEALTH DEPT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6007 N HIGHWAY 27
SCIENCE HILL KY
42553-9121
US
IV. Provider business mailing address
500 BOURNE AVE
SOMERSET KY
42501-1916
US
V. Phone/Fax
- Phone: 606-423-3341
- Fax: 606-489-3313
- Phone: 606-678-4761
- Fax: 606-676-9671
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: MR.
SHAWN
D
CRABTREE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 606-678-4761