Provider Demographics
NPI:1811179294
Name:MAGOFFIN COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:MAGOFFIN COUNTY HEALTH DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BERTIE
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:SALYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-349-6212
Mailing Address - Street 1:723 PARKWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:SALYERSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41465
Mailing Address - Country:US
Mailing Address - Phone:606-349-6212
Mailing Address - Fax:606-349-6216
Practice Address - Street 1:221 HORNET DR
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465-9100
Practice Address - Country:US
Practice Address - Phone:606-349-5190
Practice Address - Fax:606-349-5139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY15000722OtherHANDS
KY000000059385OtherBLUE CROSS/BLUE SHIELD
KY20077095Medicaid
KY0979Medicare PIN