MEDICARE: MADISON COUNTY 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

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	:	1821271396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MADISON COUNTY HEALTH DEPARTMENT

Provider Business Mailing Address
First Line	:	216 BOGGS LN
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-2522
Country	:	US
Telephone Number	:	859-623-7312
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 SUMMIT ST
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-2129
Country	:	US
Telephone Number	:	859-624-4550
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	NANCY M CREWE
Credential	:
Telephone Number	:	859-626-4241

Provider Enumeration Date	:	12/07/2007
Last Update Date	:	08/22/2013

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