| Organization Name: | MACOUPIN COUNTY PUBLIC HEALTH DEPARTMENT |
| NPI Number: | 1538444906 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENT ALAN TARRO (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 109 E Maple St Gillespie |
| State: | IL US |
| Postal Code: | 620331473 |
| Phone Number: | 2178391526 |
| Fax Number: | 2178391538 |
| NPI Enumeration Date: | 10/18/2011 |
| NPI Last Update Date: | 05/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | =========007 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |