Organization Name: | HERITAGE ELEM SCHOOL HEALTH CENTER |
NPI Number: | 1295000990 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAULA L THORNBERRY (ADMINISTRATIVE ASSISTANT) |
Mailing Address: | 4865 S St Hwy 1 Grayson |
State: | KY US |
Postal Code: | 411437634 |
Phone Number: | 6064745784 |
Fax Number: | |
NPI Enumeration Date: | 03/13/2012 |
NPI Last Update Date: | 03/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |