Provider Demographics
NPI:1518231497
Name:NORTH CENTRAL DISTRICT HEALTH DEPT
Entity Type:Organization
Organization Name:NORTH CENTRAL DISTRICT HEALTH DEPT
Other - Org Name:TRIMBLE COUNTY HIGH SCHOOL SATELLITE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:502-633-1243
Mailing Address - Street 1:1020 HENRY CLAY ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1335
Mailing Address - Country:US
Mailing Address - Phone:502-633-1243
Mailing Address - Fax:502-633-7658
Practice Address - Street 1:1029 HIGHWAY 421 N
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:KY
Practice Address - Zip Code:40006-8699
Practice Address - Country:US
Practice Address - Phone:502-633-1243
Practice Address - Fax:502-633-7658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-24
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare