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General NPI Number Information
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NPI Number | 1346395092
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Entity Type | Organization
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Legal Business Name | COUNTY OF WARREN
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 104 W BOONESLICK RD SUITE H
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City | WARRENTON
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State | MO
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Zip | 63383-1998
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Country | US
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Telephone | 636-456-7474
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Fax | 636-456-4966
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Provider Business Mailing Address
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Address Line | 104 W BOONESLICK RD SUITE H
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City | WARRENTON
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State | MO
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Zip | 63383-1998
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Country | US
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Telephone | 636-456-7474
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Fax | 636-456-4966
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Authorized Official
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Title or Position | ADMIN
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Name | MRS. RUTH ANN WALTERS
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Credential |
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Telephone | 636-456-7474
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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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