Provider Demographics
NPI:1124919097
Name:ISAIAH HOUSE, INC
Entity type:Organization
Organization Name:ISAIAH HOUSE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:LUCILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-755-7433
Mailing Address - Street 1:1090 INDUSTRY RD
Mailing Address - Street 2:
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-9140
Mailing Address - Country:US
Mailing Address - Phone:502-599-0264
Mailing Address - Fax:
Practice Address - Street 1:1092 INDUSTRY RD
Practice Address - Street 2:
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330
Practice Address - Country:US
Practice Address - Phone:502-599-0264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ISAIAH HOUSE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy