Provider Demographics
NPI:1811997661
Name:BULLITT COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:BULLITT COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:D
Authorized Official - Last Name:RENFROW
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:502-955-6680
Mailing Address - Street 1:181 LEES VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-6143
Mailing Address - Country:US
Mailing Address - Phone:502-955-7837
Mailing Address - Fax:502-543-2998
Practice Address - Street 1:181 LEES VALLEY RD
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-6143
Practice Address - Country:US
Practice Address - Phone:502-955-7837
Practice Address - Fax:502-543-2998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY87212OtherCOVENTRY CARES OF KY
1051411OtherPASSPORT HEALTH PLAN
KY15000037OtherHANDS MEDICAID
KY645482OtherWELLCARE
KY20015012Medicaid
KY15000037OtherHANDS MEDICAID
KY87212OtherCOVENTRY CARES OF KY