Provider Demographics
NPI:1710185657
Name:WOODFORD COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:WOODFORD COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:PRATHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-873-4541
Mailing Address - Street 1:229 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1240
Mailing Address - Country:US
Mailing Address - Phone:859-873-4541
Mailing Address - Fax:859-873-7238
Practice Address - Street 1:229 N MAIN ST
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1240
Practice Address - Country:US
Practice Address - Phone:859-873-4541
Practice Address - Fax:859-873-7238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYNOT APPLICABLE251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY20120010,15000573Medicaid
KY20120010Medicaid
KY20901211Medicaid