Organization Name: | DOUGLAS COUNTY HEALTH DEPARTMENT |
NPI Number: | 1649253105 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SANDRA PUEPPKE (ADMINISTRATOR) |
Mailing Address: | 603 Nw 12th St Building C Ava |
State: | MO US |
Postal Code: | 656080940 |
Phone Number: | 4176834174 |
Fax Number: | 4176834111 |
NPI Enumeration Date: | 11/29/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP0905X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Public Health, State or Local |
Taxonomy Definition: |