Provider Demographics
NPI:1104800127
Name:MARSHALL COUNTY HEALTH DEPT
Entity type:Organization
Organization Name:MARSHALL COUNTY HEALTH DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL ADMINISTRATOR PERSONNEL
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:D
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-252-2714
Mailing Address - Street 1:267 SLICKBACK RD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-7629
Mailing Address - Country:US
Mailing Address - Phone:270-527-1496
Mailing Address - Fax:270-527-5321
Practice Address - Street 1:267 SLICKBACK RD
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-7629
Practice Address - Country:US
Practice Address - Phone:270-527-1496
Practice Address - Fax:270-527-5321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-02
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY20079018Medicaid
KY0227506Medicare UPIN
KY2275Medicare UPIN
KY0227507Medicare UPIN
KYS96407Medicare UPIN
KY20079018Medicaid
KY0227505Medicare UPIN
KY0227509Medicare UPIN
KY600000626Medicare UPIN