MEDICARE: DEK HEALTH ALLIANCE

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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000334076	OTHER	KY	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285631259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEK HEALTH ALLIANCE

Provider Business Mailing Address
First Line	:	PO BOX 929
Second Line	:
City	:	MOUNT VERNON
State	:	KY
Zip	:	40456-0929
Country	:	US
Telephone Number	:	606-256-4013
Fax Number	:	606-256-1242

Provider Business Practice Location Address
First Line	:	45 NEWCOMB AVE
Second Line	:
City	:	MOUNT VERNON
State	:	KY
Zip	:	40456-2732
Country	:	US
Telephone Number	:	606-256-4013
Fax Number	:	606-256-1242

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. REBECCA GIRDLER
Credential	:
Telephone Number	:	606-256-4013

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	08/22/2020

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Directions to “DEK HEALTH ALLIANCE ” Practice Location

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