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General NPI Number Information
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NPI Number | 1255466512
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Entity Type | Organization
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Legal Business Name | LOUISVILLE JEFFERSON COUNTY METRO GOVERNMENT
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 4810 EXETER AVE
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City | LOUISVILLE
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State | KY
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Zip | 40218-3874
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Country | US
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Telephone | 502-458-1215
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Fax | 502-456-4812
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Provider Business Mailing Address
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Address Line | 400 E GRAY ST P. O. BOX 1704
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City | LOUISVILLE
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State | KY
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Zip | 40202-1740
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Country | US
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Telephone | 502-574-6514
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Fax | 502-574-6417
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Authorized Official
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Title or Position | FISCAL MANAGER
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Name | MS. ROBYN DICKERSON
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Credential | MSM
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Telephone | 502-574-6580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 251K000004
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License Number State | KY
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