Purchase District Health Dept
Organization Active NPI Public Health or Welfare Agency · Lacenter, KY
NPI 1013971720 · NPPES record last updated Apr 5, 2018
Key facts
- NPI
- 1013971720
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- PURCHASE DISTRICT HEALTH DEPT
- Practice address
- 198 Bluegrass Dr
Ballard County Health Center
Lacenter, KY 42056 - Phone
- (270) 665-5432
- Fax
- (270) 665-9166
- NPI assigned
- Apr 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Ronald K. Koster
- Title
- Director of Public Health
- Phone
- (270) 444-9625
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 31
Practitioners 1
-
Susanne Greene, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040113000019 | KY | Part B Supplier - Clinic/Group Practice | 6002716248 |
Receives reassigned benefits from 2 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Clinton, KY; Paducah, KY; Lacenter, KY; Hickman, KY; Fulton, KY; Bardwell, KY |
National Provider Directory
- Tax ID family
- Carlisle Co Elementary School Clinic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
198 Bluegrass Dr
Ballard County Health Center
Lacenter, KY 42056
Mailing address
PO Box 2357
Paducah, KY 42002
Phone (270) 444-9625
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FLU0248 | Other | MEDICARE | |
| 20004016 | Medicaid | KY | |
| 600000509 | Other | KY | MEDICARE RAILROAD |
| 8352 | Other | KY | MEDICARE |
Other providers in Lacenter, KY
All providers in Lacenter, KY · Public Health or Welfare Agency in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.