Healthcare Provider Details

I. General information

NPI: 1639376916
Provider Name (Legal Business Name): WHITLEY COUNTY HEALTH DEPT.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 N 2ND ST
WILLIAMSBURG KY
40769-1101
US

IV. Provider business mailing address

114 N 2ND ST
WILLIAMSBURG KY
40769-1101
US

V. Phone/Fax

Practice location:
  • Phone: 606-549-3380
  • Fax: 606-549-8940
Mailing address:
  • Phone: 606-549-3380
  • Fax: 606-549-8940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateKY

VIII. Authorized Official

Name: MRS. CHERYL L PARKS
Title or Position: BILLING CLERK
Credential: SA
Phone: 606-549-3380