Healthcare Provider Details

I. General information

NPI: 1265602171
Provider Name (Legal Business Name): VIGO COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 03/20/2022
Certification Date: 03/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

696 S 1ST ST
TERRE HAUTE IN
47807-4643
US

IV. Provider business mailing address

147 OAK ST
TERRE HAUTE IN
47807-3438
US

V. Phone/Fax

Practice location:
  • Phone: 812-462-3431
  • Fax: 812-231-6242
Mailing address:
  • Phone: 812-462-3428
  • Fax: 812-234-1010

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: DR. DARREN C BRUCKEN
Title or Position: HEALTH OFFICER
Credential: M.D.
Phone: 812-462-3431