Healthcare Provider Details

I. General information

NPI: 1912228420
Provider Name (Legal Business Name): PUTNAM COUNTY HEALTH DEPT.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 06/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 COUNTY SERVICES DR
COOKEVILLE TN
38501-4338
US

IV. Provider business mailing address

701 COUNTY SERVICES DR
COOKEVILLE TN
38501-4338
US

V. Phone/Fax

Practice location:
  • Phone: 931-528-2531
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBBA R ALLEN
Title or Position: NA
Credential: MA
Phone: 931-528-2531