MEDICARE: WEDCO DISTRICT HEALTH DEPARTMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency		KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073591327
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEDCO DISTRICT HEALTH DEPARTMENT

Provider Business Mailing Address
First Line	:	302 ODDVILLE AVE
Second Line	:	P O BOX 218
City	:	CYNTHIANA
State	:	KY
Zip	:	41031-1241
Country	:	US
Telephone Number	:	859-234-8750
Fax Number	:	859-234-8925

Provider Business Practice Location Address
First Line	:	2320 CONCRETE RD
Second Line	:
City	:	CARLISLE
State	:	KY
Zip	:	40311-9721
Country	:	US
Telephone Number	:	859-289-2188
Fax Number	:	859-289-2203

Authorized Official
Title or Position	:	PUBLIC HEALTH DIRECTOR
Name	:	MS. CRYSTAL CAUDILL
Credential	:
Telephone Number	:	859-234-8750

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	07/21/2022

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