Provider Demographics
NPI:1013195320
Name:DELTA-MENOMINEE DISTRICT HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:DELTA-MENOMINEE DISTRICT HEALTH DEPARTMENT
Other - Org Name:PUBLIC HEALTH, DELTA & MENOMINEE COUNTIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:C
Authorized Official - Last Name:LENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-786-4111
Mailing Address - Street 1:909 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:MENOMINEE
Mailing Address - State:MI
Mailing Address - Zip Code:49858-3014
Mailing Address - Country:US
Mailing Address - Phone:906-863-4451
Mailing Address - Fax:906-863-7142
Practice Address - Street 1:2920 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-9597
Practice Address - Country:US
Practice Address - Phone:906-786-4111
Practice Address - Fax:906-786-1962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
0B11000Medicare PIN