1831364314 NPI number — BARREN RIVER DISTRICT HEALTH DEPARTMENT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831364314 NPI number — BARREN RIVER DISTRICT HEALTH DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARREN RIVER DISTRICT HEALTH DEPARTMENT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LOGAN COUNTY HIGH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831364314
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1109 STATE ST
Provider Second Line Business Mailing Address:
P O BOX 1157
Provider Business Mailing Address City Name:
BOWLING GREEN
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42101-2648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-781-2490
Provider Business Mailing Address Fax Number:
270-796-8946

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 BOWLING GREEN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUSSELLVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42276-9602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-726-8454
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/25/2008

Additional Information

Authorized Official

Authorized Official Last Name:
CHANEY
Authorized Official First Name:
DENNIS
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PUBLIC HEALTH DIRECTOR
Authorized Official Telephone Number:
270-781-8039

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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