Provider Demographics
NPI:1326221714
Name:MADISON COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MADISON COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CREWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-626-4241
Mailing Address - Street 1:214 BOGGS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2522
Mailing Address - Country:US
Mailing Address - Phone:859-626-4233
Mailing Address - Fax:859-623-5910
Practice Address - Street 1:644 KIRKSVILLE ROAD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475
Practice Address - Country:US
Practice Address - Phone:859-624-4583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY20076063Medicaid