Provider Demographics
NPI:1285957050
Name:BARREN RIVER DISTRICT HEALTH DEPARTMENT
Entity type:Organization
Organization Name:BARREN RIVER DISTRICT HEALTH DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DISTRICT DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-781-8039
Mailing Address - Street 1:1109 STATE ST
Mailing Address - Street 2:P.O. BOX 1157
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-2648
Mailing Address - Country:US
Mailing Address - Phone:270-781-8039
Mailing Address - Fax:270-796-8946
Practice Address - Street 1:210 W CEMETERY ST
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:KY
Practice Address - Zip Code:42261-7912
Practice Address - Country:US
Practice Address - Phone:270-526-3361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY303016B251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY303016BOtherCLINIC SITE