MEDICARE: HENRY COUNTY AUDITORS OFFICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000157603	OTHER		ANTHEM

General Provider Information

NPI Number	:	1568442556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRY COUNTY AUDITORS OFFICE

Provider Business Mailing Address
First Line	:	1843 OAKWOOD AVE
Second Line	:
City	:	NAPOLEON
State	:	OH
Zip	:	43545-9243
Country	:	US
Telephone Number	:	419-599-5612
Fax Number	:	419-599-1714

Provider Business Practice Location Address
First Line	:	1843 OAKWOOD AVE
Second Line	:
City	:	NAPOLEON
State	:	OH
Zip	:	43545-9243
Country	:	US
Telephone Number	:	419-599-5612
Fax Number	:	419-599-1714

Authorized Official
Title or Position	:	PRESIDENT BOARD OF HEALTH
Name	:	MR. ROGER RICHARD
Credential	:
Telephone Number	:	419-599-5612

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	11/06/2014

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