=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457682627
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PIQUA CITY HEALTH DEPARTMENT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2010
-----------------------------------------------------
Last Update Date | 01/27/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 W WATER ST
-----------------------------------------------------
City | PIQUA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45356-2235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-778-2060
-----------------------------------------------------
Fax | 937-778-0050
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 201 W WATER ST
-----------------------------------------------------
City | PIQUA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45356-2235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-778-2060
-----------------------------------------------------
Fax | 937-778-0050
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | AMY J WELKER
-----------------------------------------------------
Credential | RS
-----------------------------------------------------
Telephone | 937-778-2060
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------