# GREEN RIVER DISTRICT HEALTH DEPARTMENT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Elementary Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568654432
- **Authorized official:** ANGEL THOMPSON (ADMINISTRATIVE SERVICE MANAGER)
- **Authorized official phone:** (270) 686-7747

## Contact information

- **Practice address:** 470 S BROADWAY ST, PROVIDENCE, KY 42450-1642
- **Practice address phone:** (270) 667-7041
- **Practice address fax:** (270) 667-5893
- **Mailing address:** 470 S BROADWAY ST, PROVIDENCE, KY 42450-1642
- **Mailing address phone:** (270) 667-7041
- **Mailing address fax:** (270) 667-5893

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | KY | Yes |

## Other

- **Enumeration date:** 08/15/2007
- **Last updated:** 12/23/2008