Healthcare Provider Details

I. General information

NPI: 1427174127
Provider Name (Legal Business Name): WABASH COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W 7TH ST
MOUNT CARMEL IL
62863-1439
US

IV. Provider business mailing address

130 W 7TH ST
MOUNT CARMEL IL
62863-1439
US

V. Phone/Fax

Practice location:
  • Phone: 618-263-3873
  • Fax: 618-262-4215
Mailing address:
  • Phone: 618-263-3873
  • Fax: 618-262-4215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateIL

VIII. Authorized Official

Name: MRS. CYNTHIA BROWN
Title or Position: AGENCY ADMINISTRATOR
Credential: MS, LCPC
Phone: 618-263-3873