Provider Demographics
NPI:1861524142
Name:GATEWAY DISTRICT HEALTH DEPARTMENT
Entity type:Organization
Organization Name:GATEWAY DISTRICT HEALTH DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATIVE SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-674-6396
Mailing Address - Street 1:PO BOX 555
Mailing Address - Street 2:
Mailing Address - City:OWINGSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40360
Mailing Address - Country:US
Mailing Address - Phone:606-674-6396
Mailing Address - Fax:606-674-3071
Practice Address - Street 1:730 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-1444
Practice Address - Country:US
Practice Address - Phone:606-784-8954
Practice Address - Fax:606-783-1443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1811246143OtherJESSICA LYKINS, APRN
KY1376742932OtherWENDY LYKINGS, ARNP
KY20103016Medicaid
KY1023051208OtherCINDY CRAGER, ARNP
KY1588668339OtherDR. ESKEW
KY78010220OtherSHANNON SMITH STEPHENS
KY1942409511OtherBRENDA WILBURN, ARNP
KY1255326104OtherJUDY LEE, ARNP
KY1558561910OtherSANDRA ELLIINGTON, MS,RD
KYP00194365OtherMEDICARE RAILROAD
KY1588668339OtherDR. ESKEW
KYFLU0202Medicare PIN