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General NPI Number Information
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NPI Number | 1730497678
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Entity Type | Organization
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Legal Business Name | NORTHERN KENTUCKY INDEPENDENT DISTRICT HEALTH DEPARTMENT
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 2500 MADISON AVE
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City | COVINGTON
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State | KY
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Zip | 41014-1658
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Country | US
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Telephone | 859-655-9545
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Fax | 859-581-7259
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Provider Business Mailing Address
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Address Line | 610 MEDICAL VILLAGE DR
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City | EDGEWOOD
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State | KY
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Zip | 41017-3416
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Country | US
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Telephone | 859-341-4264
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Fax | 859-578-3689
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Authorized Official
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Title or Position | INTERIM DISTRICT DIRECTOR OF HEALT
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Name | MR. GEORGE A MOORE
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Credential |
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Telephone | 859-344-5461
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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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