Provider Demographics
NPI:1730248063
Name:CUMBERLAND VALLEY DISTRICT HEALTH DEPARTMENT HOSPICE
Entity type:Organization
Organization Name:CUMBERLAND VALLEY DISTRICT HEALTH DEPARTMENT HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOSPICE DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-287-8437
Mailing Address - Street 1:PO BOX 670
Mailing Address - Street 2:HIGHWAY 290
Mailing Address - City:MC KEE
Mailing Address - State:KY
Mailing Address - Zip Code:40447-0670
Mailing Address - Country:US
Mailing Address - Phone:606-287-8437
Mailing Address - Fax:606-287-8438
Practice Address - Street 1:US HIGHWAY 290
Practice Address - Street 2:
Practice Address - City:MC KEE
Practice Address - State:KY
Practice Address - Zip Code:40447-0670
Practice Address - Country:US
Practice Address - Phone:606-287-8437
Practice Address - Fax:606-287-8438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY400034251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY44026001Medicaid
KY44026001Medicaid