Provider Demographics
NPI:1003805755
Name:WYANDOT COUNTY OFFICE OF AUDITOR
Entity Type:Organization
Organization Name:WYANDOT COUNTY OFFICE OF AUDITOR
Other - Org Name:WYANDOT COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:WYANDOT COUNTY HEALTH COMMISSIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:KERI
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-294-3852
Mailing Address - Street 1:127 S SANDUSKY AVE RM A
Mailing Address - Street 2:
Mailing Address - City:UPPER SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:43351-1451
Mailing Address - Country:US
Mailing Address - Phone:419-294-3852
Mailing Address - Fax:419-294-6435
Practice Address - Street 1:127 S SANDUSKY AVE
Practice Address - Street 2:ROOM A
Practice Address - City:UPPER SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:43351-1451
Practice Address - Country:US
Practice Address - Phone:419-294-3852
Practice Address - Fax:419-294-6435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0547135Medicaid
OHFV91391Medicare PIN