Provider Demographics
NPI:1255538435
Name:BRECKINRIDGE COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:BRECKINRIDGE COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HENNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-756-5121
Mailing Address - Street 1:220 S HARDIN ST
Mailing Address - Street 2:PO BOX 456
Mailing Address - City:HARDINSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40143-2613
Mailing Address - Country:US
Mailing Address - Phone:270-756-2282
Mailing Address - Fax:270-756-9090
Practice Address - Street 1:220 S HARDIN ST
Practice Address - Street 2:
Practice Address - City:HARDINSBURG
Practice Address - State:KY
Practice Address - Zip Code:40143-2613
Practice Address - Country:US
Practice Address - Phone:270-756-2282
Practice Address - Fax:270-756-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21716251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2435963000OtherPASSPORT ADVANTAGE
KY1092809OtherPASSPORT
KY20014015Medicaid
KY2435963000OtherPASSPORT ADVANTAGE