Provider Demographics
NPI:1851517635
Name:BOURBON COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:BOURBON COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:B
Authorized Official - Last Name:BECKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-987-1915
Mailing Address - Street 1:341 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-2116
Mailing Address - Country:US
Mailing Address - Phone:859-987-1915
Mailing Address - Fax:859-987-3230
Practice Address - Street 1:341 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2116
Practice Address - Country:US
Practice Address - Phone:859-987-1915
Practice Address - Fax:859-987-3230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY600000539OtherRAILROAD MEDICARE
KY15000623Medicaid
KY20009015Medicaid
KYC78511Medicare UPIN
KY20009015Medicaid
KY0698004Medicare ID - Type Unspecified
KY600000539OtherRAILROAD MEDICARE