Cumberland Valley Dist. HLTH Dept

Organization Active NPI Public Health or Welfare Agency · Harlan, KY

NPI 1770625964 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1770625964
Entity type
Organization (NPI type 2)
Primary specialty
Public Health or Welfare Agency 251K00000X
Legal business name
CUMBERLAND VALLEY DIST. HLTH DEPT
Practice address
402 E Clover St
Harlan, KY 40831-2312
Phone
(606) 573-4820
Fax
(606) 573-6128
NPI assigned
Feb 13, 2007
Organization subpart
No

Authorized official

Name
Herman Johnson
Title
Administrator
Phone
(606) 598-5564

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031121000660 KY Part B Supplier - Clinic/Group Practice 1456255330 Receives reassigned benefits from 3 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manchester, KY; MC Kee, KY; Mount Vernon, KY

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Yes

Addresses

Primary practice location

402 E Clover St
Harlan, KY 40831-2312

Mailing address

PO Box 158
Manchester Square Shopping Ctr. Room 212
Manchester, KY 40962-0158
Phone (606) 598-5564

Other names

  • Harlan Co. Health Dept. Other name

Other providers in Harlan, KY

All providers in Harlan, KY · Public Health or Welfare Agency in Kentucky

Sources for this page

Verify at the official NPI Registry.