Provider Demographics
NPI:1548382500
Name:LINCOLN COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:LINCOLN COUNTY HEALTH DEPARTMENT
Other - Org Name:SCHOOL HEALTH OFFICE WAYNESBURG ELEMENTARY SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PUBLIC HEALTH ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-365-3106
Mailing Address - Street 1:PO BOX 265
Mailing Address - Street 2:305 DANVILLE AVE
Mailing Address - City:STANFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40484-0265
Mailing Address - Country:US
Mailing Address - Phone:606-365-7287
Mailing Address - Fax:606-365-8911
Practice Address - Street 1:345 WAYNESBURG ROAD
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:KY
Practice Address - Zip Code:40489
Practice Address - Country:US
Practice Address - Phone:606-379-6413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYC74576Medicare UPIN
KY20000790Medicare UPIN
KYFLU0267Medicare ID - Type Unspecified