Provider Demographics
NPI:1669506010
Name:LAWRENCE CO. HEALTHE DEPT
Entity Type:Organization
Organization Name:LAWRENCE CO. HEALTHE DEPT
Other - Org Name:EAST ELEMENTARY SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-638-4389
Mailing Address - Street 1:1080 MEADOWBROOK LN
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230-9657
Mailing Address - Country:US
Mailing Address - Phone:606-638-4389
Mailing Address - Fax:606-638-3008
Practice Address - Street 1:235 E POWHATAN ST
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230-1346
Practice Address - Country:US
Practice Address - Phone:606-638-4389
Practice Address - Fax:606-638-3008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY20001178Medicaid