Healthcare Provider Details

I. General information

NPI: 1114000270
Provider Name (Legal Business Name): DAVIESS COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609A S MAIN ST
GALLATIN MO
64640-1447
US

IV. Provider business mailing address

609A S MAIN ST
GALLATIN MO
64640-1447
US

V. Phone/Fax

Practice location:
  • Phone: 660-663-2414
  • Fax: 660-663-3919
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. JANET MCMAHON
Title or Position: OFFICE MANAGER
Credential:
Phone: 660-663-2414