Healthcare Provider Details

I. General information

NPI: 1316974595
Provider Name (Legal Business Name): COUNTY OF MORGAN HEALTH DEPT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 06/08/2022
Certification Date: 05/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E STATE STREET
JACKSONVILLE IL
62650-2125
US

IV. Provider business mailing address

425 E STATE STREET
JACKSONVILLE IL
62650-2125
US

V. Phone/Fax

Practice location:
  • Phone: 217-245-5111
  • Fax: 217-243-4773
Mailing address:
  • Phone: 217-245-5111
  • Fax: 217-243-4773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DALE A BAINTER
Title or Position: PUBLIC HEALTH ADMINISTRATOR
Credential: BS
Phone: 217-245-5111