Provider Demographics
NPI:1053320929
Name:MONTGOMERY COUNTY TREAS COURT HOUSE
Entity Type:Organization
Organization Name:MONTGOMERY COUNTY TREAS COURT HOUSE
Other - Org Name:MONTGOMERY COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH DIRECTOR/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:DIMINO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-278-5117
Mailing Address - Street 1:1430 DEKALB ST PO BOX 311
Mailing Address - Street 2:MONTGOMERY COUNTY HEALTH DEPARTMENT
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19404-0311
Mailing Address - Country:US
Mailing Address - Phone:610-278-5117
Mailing Address - Fax:610-278-5167
Practice Address - Street 1:1430 DEKALB ST
Practice Address - Street 2:MONTGOMERY COUNTY HEALTH DEPARTMENT
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19404-0311
Practice Address - Country:US
Practice Address - Phone:610-278-5117
Practice Address - Fax:610-278-5167
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF MONTGOMERY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-07
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100072290052Medicaid