Provider Demographics
NPI:1811032816
Name:ALLEN COUNTY HEALTH DEPT
Entity Type:Organization
Organization Name:ALLEN COUNTY HEALTH DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-237-4423
Mailing Address - Street 1:107 N COURT ST
Mailing Address - Street 2:P.O. BOX129
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42164-1429
Mailing Address - Country:US
Mailing Address - Phone:270-237-4423
Mailing Address - Fax:270-237-4777
Practice Address - Street 1:107 N COURT ST
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164-1429
Practice Address - Country:US
Practice Address - Phone:270-237-4423
Practice Address - Fax:270-237-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY20002010Medicaid
KY15000615Medicaid
KY45347846Medicaid
KYP00170137Medicare PIN
KY20002010Medicaid