Provider Demographics
NPI:1558521138
Name:MONROE COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:MONROE COUNTY HEALTH DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-487-6782
Mailing Address - Street 1:452 EAST 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:TOMPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42167-1667
Mailing Address - Country:US
Mailing Address - Phone:270-487-6782
Mailing Address - Fax:270-487-5457
Practice Address - Street 1:600 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TOMPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42167-1552
Practice Address - Country:US
Practice Address - Phone:270-487-9624
Practice Address - Fax:270-487-5457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100062210Medicaid