Provider Demographics
NPI:1639264195
Name:MADISON COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MADISON COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NIKITA
Authorized Official - Middle Name:
Authorized Official - Last Name:VUNDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-626-4241
Mailing Address - Street 1:214 BOGGS LANE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40403
Mailing Address - Country:US
Mailing Address - Phone:859-623-7312
Mailing Address - Fax:859-623-5910
Practice Address - Street 1:214 BOGGS LANE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475
Practice Address - Country:US
Practice Address - Phone:859-623-7312
Practice Address - Fax:859-623-5910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY20076014Medicaid
KY0777OtherMEDICARE GROUP
KY20076022Medicaid
15000268OtherHANDS
KY71000008Medicaid
KYFLU0101Medicare ID - Type UnspecifiedFLU PROVIDER NUMBER