Provider Demographics
NPI:1942284864
Name:TODD COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:TODD COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:MARIEL
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:270-265-2362
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:205 MCREYNOLDS DR
Mailing Address - City:ELKTON
Mailing Address - State:KY
Mailing Address - Zip Code:42220-0305
Mailing Address - Country:US
Mailing Address - Phone:270-265-2362
Mailing Address - Fax:270-265-0602
Practice Address - Street 1:205 MCREYNOLDS DR
Practice Address - Street 2:
Practice Address - City:EKTON
Practice Address - State:KY
Practice Address - Zip Code:42220
Practice Address - Country:US
Practice Address - Phone:270-265-2362
Practice Address - Fax:270-265-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY20110011Medicaid
KYFLU0285Medicare ID - Type Unspecified