Provider Demographics
NPI:1407830706
Name:KNOX COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:KNOX COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-546-5919
Mailing Address - Street 1:261 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906-7356
Mailing Address - Country:US
Mailing Address - Phone:606-546-5919
Mailing Address - Fax:606-546-2168
Practice Address - Street 1:261 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:BARBOURVILLE
Practice Address - State:KY
Practice Address - Zip Code:40906-7356
Practice Address - Country:US
Practice Address - Phone:606-546-5919
Practice Address - Fax:606-546-2168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-01
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY150018251B00000X, 251E00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY42001610Medicaid
KY34001610Medicaid
KY20061016Medicaid
KY45346350Medicaid
KY20061016Medicaid
KY45346350Medicaid