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General NPI Number Information
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NPI Number | 1891763876
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Entity Type | Organization
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Legal Business Name | LICKING COUNTY
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 675 PRICE RD NE
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City | NEWARK
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State | OH
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Zip | 43055-9454
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Country | US
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Telephone | 740-349-6535
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Fax | 740-349-6510
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Provider Business Mailing Address
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Address Line | 675 PRICE RD NE
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City | NEWARK
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State | OH
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Zip | 43055-9454
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Country | US
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Telephone | 740-349-6535
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Fax | 740-349-6935
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Authorized Official
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Title or Position | HEALTH COMMISSIONER
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Name | MR. R. JOSEPH EBEL
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Credential | R.S, M.S, M.B.A
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Telephone | 740-349-6535
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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 | 35-04-2030-M
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License Number State | OH
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