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General NPI Number Information
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NPI Number | 1104876788
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Entity Type | Organization
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Legal Business Name | HENRY COUNTY HEALTH CENTER
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 306 S 2ND ST
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City | CLINTON
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State | MO
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Zip | 64735-2106
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Country | US
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Telephone | 660-885-8193
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Fax | 660-885-7744
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Provider Business Mailing Address
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Address Line | 306 S 2ND ST
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City | CLINTON
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State | MO
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Zip | 64735-2106
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Country | US
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Telephone | 660-885-8193
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Fax | 660-885-7744
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BONNIE GLASS
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Credential |
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Telephone | 660-885-8193
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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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