MEDICARE: HICKORY COUNTY HEALTH DEPARTMENT

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	:	1750416251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HICKORY COUNTY HEALTH DEPARTMENT

Provider Business Mailing Address
First Line	:	PO BOX 21
Second Line	:
City	:	HERMITAGE
State	:	MO
Zip	:	65668-0021
Country	:	US
Telephone Number	:	417-745-2138
Fax Number	:	417-745-2400

Provider Business Practice Location Address
First Line	:	24885 STATE HWY 254
Second Line	:
City	:	HERMITAGE
State	:	MO
Zip	:	65668-0144
Country	:	US
Telephone Number	:	417-745-2138
Fax Number	:	417-745-2400

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. DAWN VADER
Credential	:
Telephone Number	:	417-745-2138

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	05/24/2024

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Directions to “HICKORY COUNTY HEALTH DEPARTMENT ” Practice Location

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