Organization
LOUISVILLE-JEFFERSON COUNTY METRO GOVERNMENT
Active
Other names
Louisville Metro Depart of Public Health & Wellness-NP South Jefferson
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBYN M DICKERSON MSM (FISCAL MANAGER)
(502) 574-6580
Entity
Organization
Contact information
Practice address
1000 NEIGHBORHOOD PL, FAIRDALE, KY 40118-9697
(502) 363-1428
(502) 363-1463
Mailing address
400 E GRAY ST, P.O. BOX 1704, LOUISVILLE, KY 40202-1740
(502) 574-6514
(502) 574-6417
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
251K00004
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1051419
PASSPORT MANAGED CARE NUM
KY
05
—
20056263
—
KY
Enumeration date
02/23/2007
Last updated
04/22/2024
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