Provider Demographics
NPI:1295129989
Name:GREENUP COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:GREENUP COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:CRUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-473-9838
Mailing Address - Street 1:PO BOX 377
Mailing Address - Street 2:
Mailing Address - City:GREENUP
Mailing Address - State:KY
Mailing Address - Zip Code:41144-0377
Mailing Address - Country:US
Mailing Address - Phone:606-473-9838
Mailing Address - Fax:606-473-6405
Practice Address - Street 1:425 JAMES HANNAH DRIVE
Practice Address - Street 2:STE 2
Practice Address - City:SOUTH SHORE
Practice Address - State:KY
Practice Address - Zip Code:41175-9998
Practice Address - Country:US
Practice Address - Phone:606-932-4546
Practice Address - Fax:606-932-3885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1285897652OtherNPI FOR APRN
KY15000052Medicaid
KY600000625OtherRAILROAD MEDICARE
KY600000625OtherRAILROAD MEDICARE
KY15000052Medicaid
KY0274003Medicare PIN