Healthcare Provider Details

I. General information

NPI: 1528379906
Provider Name (Legal Business Name): COUNTY OF FULTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N MAIN ST
LEWISTOWN IL
61542-0111
US

IV. Provider business mailing address

100 N MAIN ST PO BOX 111
LEWISTOWN IL
61542-0111
US

V. Phone/Fax

Practice location:
  • Phone: 309-547-3041
  • Fax: 309-547-0399
Mailing address:
  • Phone: 309-547-3041
  • Fax: 309-547-0399

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: MS. VICTORIA JEAN HARPER
Title or Position: FULTON COUNTY TREASURER
Credential:
Phone: 309-547-3041