Provider Demographics
NPI:1174650675
Name:LEXINGTON FAYETTE URBAN COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:LEXINGTON FAYETTE URBAN COUNTY HEALTH DEPARTMENT
Other - Org Name:HANDS
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINIC SERVICES TEAM LEADER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-288-2311
Mailing Address - Street 1:650 NEWTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-1113
Mailing Address - Country:US
Mailing Address - Phone:859-288-2311
Mailing Address - Fax:859-288-2313
Practice Address - Street 1:650 NEWTOWN PIKE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1113
Practice Address - Country:US
Practice Address - Phone:859-288-2311
Practice Address - Fax:859-288-2313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY15001183Medicaid