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Organization

JESSAMINE COUNTY HEALTH DEPARTMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GARRY R. GOOCH (PUBLIC HEALTH DIRECTOR)
(859) 885-4149
Entity
Organization

Contact information

Practice address
210 E WALNUT ST, NICHOLASVILLE, KY 40356-1252
(859) 885-4149
(859) 885-1863
Mailing address
210 E WALNUT ST, NICHOLASVILLE, KY 40356-1252
(859) 885-4149
(859) 885-1863

Taxonomy

Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
KY
261QP0905X
State or Local Public Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20057014
KY
01
FLU0309
MEDICARE FLU
KY
Enumeration date
12/28/2005
Last updated
03/22/2013
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