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General NPI Number Information
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NPI Number | 1023099439
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Entity Type | Organization
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Legal Business Name | AUDRAIN COUNTY HEALTH CENTER
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Dates
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Enumeration Date | 11/11/2005
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 1130 S ELMWOOD DRIVE
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City | MEXICO
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State | MO
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Zip | 65265-0957
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Country | US
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Telephone | 573-581-1332
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Fax | 573-581-6652
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Provider Business Mailing Address
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Address Line | 1130 S ELMWOOD DRIVE
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City | MEXICO
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State | MO
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Zip | 65265-0957
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Country | US
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Telephone | 573-581-1332
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Fax | 573-581-6652
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CRAIG BRACE
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Credential |
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Telephone | 573-581-1332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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