1346246212 NPI number — CLAY COUNTY HEALTH DEPARTMENT

Table of content: (NPI 1346246212)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346246212 NPI number — CLAY COUNTY HEALTH DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLAY COUNTY HEALTH DEPARTMENT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CLAY COUNTY PUBLIC HEALTH CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346246212
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 HAINES DR.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIBERTY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
816-595-4208
Provider Business Mailing Address Fax Number:
816-595-4201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 HAINES DR.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIBERTY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-595-4208
Provider Business Practice Location Address Fax Number:
816-595-4201
Provider Enumeration Date:
06/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MEINKE
Authorized Official First Name:
DARRELL
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF PUBLIC HEALTH
Authorized Official Telephone Number:
816-200-3103

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 304540 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 700887 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 205045909 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 23796015 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 720600 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 35649 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 510903800 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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