Provider Demographics
NPI:1437295854
Name:MADISON COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MADISON COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSING ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:859-626-4509
Mailing Address - Street 1:216 BOGGS LANE
Mailing Address - Street 2:P.O. BOX 1208
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40476
Mailing Address - Country:US
Mailing Address - Phone:859-626-4509
Mailing Address - Fax:859-624-1024
Practice Address - Street 1:216 BOGGS LANE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40476
Practice Address - Country:US
Practice Address - Phone:859-626-4509
Practice Address - Fax:859-624-1024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or WelfareGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY42001768Medicaid