Provider Demographics
NPI:1598894354
Name:BEDFORD COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:BEDFORD COUNTY HEALTH DEPARTMENT
Other - Org Name:STATE OF TENNESSEE DEPARTMENT OF HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:NURSE PRACTITONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:931-684-3426
Mailing Address - Street 1:140 DOVER ST
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37160-2776
Mailing Address - Country:US
Mailing Address - Phone:931-684-3426
Mailing Address - Fax:931-684-5860
Practice Address - Street 1:1606 COLLINS HOLLOW RD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-4058
Practice Address - Country:US
Practice Address - Phone:931-359-3634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006819261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local