1821148263 NPI number — GRANT COUNTY AUDITOR

Table of content: (NPI 1821148263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821148263 NPI number — GRANT COUNTY AUDITOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GRANT COUNTY AUDITOR
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:
GRANT COUNTY HEALTH DEPT/NURSING DIVISION
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:
1821148263
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 S ADAMS ST
Provider Second Line Business Mailing Address:
NURSING DIVISION
Provider Business Mailing Address City Name:
MARION
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46953-2037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
765-662-0377
Provider Business Mailing Address Fax Number:
765-662-9028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 S ADAMS ST
Provider Second Line Business Practice Location Address:
NURSING DIVISION
Provider Business Practice Location Address City Name:
MARION
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46953-2037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-662-0377
Provider Business Practice Location Address Fax Number:
765-662-9028
Provider Enumeration Date:
01/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MOORE
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
GRANT COUNTY HEALTH OFFICER
Authorized Official Telephone Number:
765-662-0377

Provider Taxonomy Codes

  • Taxonomy code: 163WC1500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: TA0060 . This is a "MEDICARE PART B" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: TA0060 . This is a "MEDICARE PTAN #" identifier . This identifiers is of the category "OTHER".




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