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General NPI Number Information
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NPI Number | 1922288356
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Entity Type | Organization
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Legal Business Name | CUMBERLAND VALLEY DIST. HEALTH DEPT.
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | HWY 221
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City | KETTLE ISLAND
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State | KY
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Zip | 40958
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Country | US
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Telephone | 606-337-3410
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Fax | 606-337-5180
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Provider Business Mailing Address
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Address Line | PO BOX 158
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City | MANCHESTER
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State | KY
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Zip | 40962
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Country | US
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Telephone | 606-598-5564
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Fax | 606-598-6615
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | HERMAN JOHNSON
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Credential |
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Telephone | 606-598-5564
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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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