Provider Demographics
NPI:1275513111
Name:GREEN RIVER DISTRICT HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:GREEN RIVER DISTRICT HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:M
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DENHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-686-7747
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:GREEN RIVER DISTRICT HEALTH DEPARTMENT
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42302-0309
Mailing Address - Country:US
Mailing Address - Phone:270-686-7747
Mailing Address - Fax:270-926-9862
Practice Address - Street 1:1501 BRECKENRIDGE ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-1054
Practice Address - Country:US
Practice Address - Phone:270-686-7744
Practice Address - Fax:270-926-8677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare