MEDICARE: NORTH CENTRAL DISTRICT HEALTH DEPT.

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	FLU0295	OTHER	KY	MEDICARE-FLU
4	K139100	OTHER	KY	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1051433	OTHER	PASSPORT

General Provider Information

NPI Number	:	1619949468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH CENTRAL DISTRICT HEALTH DEPT.

Provider Business Mailing Address
First Line	:	1020 HENRY CLAY ST
Second Line	:
City	:	SHELBYVILLE
State	:	KY
Zip	:	40065
Country	:	US
Telephone Number	:	502-633-1243
Fax Number	:	502-633-7658

Provider Business Practice Location Address
First Line	:	138 MILLER LANE
Second Line	:
City	:	BEDFORD
State	:	KY
Zip	:	40006
Country	:	US
Telephone Number	:	502-255-7701
Fax Number	:	502-255-3760

Authorized Official
Title or Position	:	PUBLIC HEALTH DIRECTOR
Name	:	MS. ROANYA RICE
Credential	:	MBA, BSN, RN
Telephone Number	:	502-633-1243

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	10/03/2024

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Directions to “NORTH CENTRAL DISTRICT HEALTH DEPT. ” Practice Location

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