1447200746 NPI number — MADISON COUNTY HEALTH DEPARTMENT

Table of content: (NPI 1447200746)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447200746 NPI number — MADISON COUNTY HEALTH DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MADISON 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:
Provider Other Organization Name Type Code:
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:
1447200746
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 ARMORY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREDERICKTOWN
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63645-1341
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-783-2747
Provider Business Mailing Address Fax Number:
573-783-8039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 ARMORY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERICKTOWN
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63645-1341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-783-2747
Provider Business Practice Location Address Fax Number:
573-783-8039
Provider Enumeration Date:
05/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WHITE
Authorized Official First Name:
ALICA
Authorized Official Middle Name:
K
Authorized Official Title or Position:
BILLING SUPERVISOR
Authorized Official Telephone Number:
573-783-2747

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: 1447200746 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "HEALTHLINK," identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "AETNA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "NEW ERA LIFE INSURANCE COMPANY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "ANTHEM BCBS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "AMBETTER-HOME STATE HEALTH" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1447200746 . This is a "HARMONY HEALTHCARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "CIGNA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "GOLDEN RULE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "COX HEALTH PLAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "PHYSICIANS HEALTH PLAN-GLOBAL CARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "MISSOURI CARE PLAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "HEALTHCARE USA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "MERITAIN HEALTH" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "MERCY HEALTH PLAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "CARE IMPROVEMENT PLUS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1447200746 . This is a "ALL SAVERS INSURANCE CO" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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