Provider Demographics
NPI:1083800064
Name:COUNTY OF LINCOLN
Entity Type:Organization
Organization Name:COUNTY OF LINCOLN
Other - Org Name:LINCOLN COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:HERSIL
Authorized Official - Suffix:
Authorized Official - Credentials:CHES
Authorized Official - Phone:715-536-0307
Mailing Address - Street 1:607 N SALES ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MERRILL
Mailing Address - State:WI
Mailing Address - Zip Code:54452-1624
Mailing Address - Country:US
Mailing Address - Phone:715-536-0307
Mailing Address - Fax:715-536-2011
Practice Address - Street 1:607 N SALES ST
Practice Address - Street 2:
Practice Address - City:MERRILL
Practice Address - State:WI
Practice Address - Zip Code:54452-1624
Practice Address - Country:US
Practice Address - Phone:715-536-0307
Practice Address - Fax:715-536-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI541OtherSTATE LAB OF HYGIENE
WI9-419-436OtherMEDICAID HMO - SHP
WI41860300Medicaid
WI44019000Medicaid
WI9-419-436OtherMEDICAID HMO - SHP
WI541OtherSTATE LAB OF HYGIENE