Provider Demographics
NPI:1790966216
Name:LEXINGTONFAYETTE COUNTY HEALTH DEPT
Entity Type:Organization
Organization Name:LEXINGTONFAYETTE COUNTY HEALTH DEPT
Other - Org Name:JR EWAN ELEMENTARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TEAM LEAD
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-288-2311
Mailing Address - Street 1:650 NEWTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508
Mailing Address - Country:US
Mailing Address - Phone:859-288-2311
Mailing Address - Fax:
Practice Address - Street 1:350 HENRY CLAY BLVD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502
Practice Address - Country:US
Practice Address - Phone:859-381-3462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100012240Medicaid