Provider Demographics
NPI:1093754996
Name:COUNTY OF RED WILLOW
Entity Type:Organization
Organization Name:COUNTY OF RED WILLOW
Other - Org Name:RED WILLOW COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNTY HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARCEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:308-345-1790
Mailing Address - Street 1:1400 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MC COOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-2552
Mailing Address - Country:US
Mailing Address - Phone:308-345-1790
Mailing Address - Fax:308-345-1794
Practice Address - Street 1:1400 W 5TH ST
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-2552
Practice Address - Country:US
Practice Address - Phone:308-345-1790
Practice Address - Fax:308-345-1794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE087024Medicare PIN
NE600000374Medicare PIN