1265466569 NPI number — HARRISON COUNTY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265466569 NPI number — HARRISON COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARRISON COUNTY
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:
Provider Other Organization Name Type Code:
6
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:
1265466569
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 175
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CADIZ
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43907-0175
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-942-4623
Provider Business Mailing Address Fax Number:
740-942-4090

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 WEST MARKET STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CADIZ
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43907-1132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-942-4623
Provider Business Practice Location Address Fax Number:
740-942-4090
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
THOMAS
Authorized Official First Name:
ASTACHEA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
ADMINISTRATIVE ASSISTANT
Authorized Official Telephone Number:
740-942-8867

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: N6001338 . This is a "HEALTH PLAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0257261 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590532012 . This is a "RAILROAD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 863223 . This is a "BLACK LUNG" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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