Provider Demographics
NPI:1043499239
Name:DEPARTMENT FOR PUBLIC HEALTH
Entity Type:Organization
Organization Name:DEPARTMENT FOR PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SPECIALIST III
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-564-7213
Mailing Address - Street 1:275 EAST MAIN STREET
Mailing Address - Street 2:HS1WB
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40621-0001
Mailing Address - Country:US
Mailing Address - Phone:502-564-7213
Mailing Address - Fax:502-564-0919
Practice Address - Street 1:275 EAST MAIN STREET
Practice Address - Street 2:HS1WB
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40621-0001
Practice Address - Country:US
Practice Address - Phone:502-564-7213
Practice Address - Fax:502-564-0919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY20001160Medicaid