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General NPI Number Information
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NPI Number | 1912041641
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Entity Type | Organization
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Legal Business Name | LAKE CUMBERLAND DISTRICT HEALTH DEPARTMENT
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 08/04/2010
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Provider Practice Location Address
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Address Line | 45 ROBERTS ST
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City | SOMERSET
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State | KY
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Zip | 42501-1295
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Country | US
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Telephone | 606-679-4416
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Fax | 606-679-4419
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Provider Business Mailing Address
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Address Line | 500 BOURNE AVE
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City | SOMERSET
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State | KY
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Zip | 42501-1916
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Country | US
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Telephone | 606-678-4761
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Fax | 606-676-9671
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. SHAWN D. CRABTREE
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Credential |
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Telephone | 606-678-4761
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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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