Provider Demographics
NPI:1831379700
Name:YORK, MEREDITH (CASE MANAGER)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:YORK
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 931
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42210-0931
Mailing Address - Country:US
Mailing Address - Phone:270-597-2713
Mailing Address - Fax:270-597-2928
Practice Address - Street 1:205 MOHAWK DR.
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42210
Practice Address - Country:US
Practice Address - Phone:270-597-2713
Practice Address - Fax:270-597-2928
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30604011Medicaid