Provider Demographics
NPI:1013971720
Name:PURCHASE DISTRICT HEALTH DEPT
Entity Type:Organization
Organization Name:PURCHASE DISTRICT HEALTH DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUBLIC HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:K
Authorized Official - Last Name:KOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-444-9625
Mailing Address - Street 1:PO BOX 2357
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002
Mailing Address - Country:US
Mailing Address - Phone:270-444-9625
Mailing Address - Fax:270-575-5458
Practice Address - Street 1:198 BLUEGRASS DR
Practice Address - Street 2:BALLARD COUNTY HEALTH CENTER
Practice Address - City:LACENTER
Practice Address - State:KY
Practice Address - Zip Code:42056
Practice Address - Country:US
Practice Address - Phone:270-665-5432
Practice Address - Fax:270-665-9166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0248OtherMEDICARE
KY20004016Medicaid
KY600000509OtherMEDICARE RAILROAD
KY8352OtherMEDICARE