Healthcare Provider Details

I. General information

NPI: 1750416251
Provider Name (Legal Business Name): HICKORY COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 05/24/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24885 STATE HWY 254
HERMITAGE MO
65668-0144
US

IV. Provider business mailing address

PO BOX 21
HERMITAGE MO
65668-0021
US

V. Phone/Fax

Practice location:
  • Phone: 417-745-2138
  • Fax: 417-745-2400
Mailing address:
  • Phone: 417-745-2138
  • Fax: 417-745-2400

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: MRS. DAWN VADER
Title or Position: ADMINISTRATOR
Credential:
Phone: 417-745-2138