MEDICARE: COUNTY OF MORGAN HEALTH DEPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316974595
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF MORGAN HEALTH DEPT

Provider Business Mailing Address
First Line	:	425 E STATE STREET
Second Line	:
City	:	JACKSONVILLE
State	:	IL
Zip	:	62650-2125
Country	:	US
Telephone Number	:	217-245-5111
Fax Number	:	217-243-4773

Provider Business Practice Location Address
First Line	:	425 E STATE STREET
Second Line	:
City	:	JACKSONVILLE
State	:	IL
Zip	:	62650-2125
Country	:	US
Telephone Number	:	217-245-5111
Fax Number	:	217-243-4773

Authorized Official
Title or Position	:	PUBLIC HEALTH ADMINISTRATOR
Name	:	MR. DALE A BAINTER
Credential	:	BS
Telephone Number	:	217-245-5111

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	06/08/2022

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Directions to “COUNTY OF MORGAN HEALTH DEPT ” Practice Location

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