Organization Name: | ST CLAIR COUNTY HEALTH CENTER |
NPI Number: | 1013966654 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NANCY MARY STEPHAN (CFO/ADMINISTRATOR) |
Mailing Address: | 530 Arduser Dr Osceola |
State: | MO US |
Postal Code: | 647766284 |
Phone Number: | 4176468157 |
Fax Number: | 4176468159 |
NPI Enumeration Date: | 05/10/2006 |
NPI Last Update Date: | 06/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP0905X |
License Number: | 96-21 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Public Health, State or Local |
Taxonomy Definition: |