Provider Demographics
NPI:1871939868
Name:HARLAN COUNTY HEALTH DEPARTMENT INC/CUMBERLAND ELEMENTARY SCHOOL
Entity type:Organization
Organization Name:HARLAN COUNTY HEALTH DEPARTMENT INC/CUMBERLAND ELEMENTARY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BOBBIE
Authorized Official - Middle Name:V
Authorized Official - Last Name:CRIDER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:606-573-3700
Mailing Address - Street 1:402 E CLOVER ST
Mailing Address - Street 2:
Mailing Address - City:HARLAN
Mailing Address - State:KY
Mailing Address - Zip Code:40831-2312
Mailing Address - Country:US
Mailing Address - Phone:606-573-3700
Mailing Address - Fax:606-573-6128
Practice Address - Street 1:322 GOLF COURSE RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:KY
Practice Address - Zip Code:40823-1908
Practice Address - Country:US
Practice Address - Phone:606-589-2511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-16
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004105251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare