Provider Demographics
NPI:1134322787
Name:COUNTY OF BROWN
Entity Type:Organization
Organization Name:COUNTY OF BROWN
Other - Org Name:DBA BROWN COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:XIONG
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:920-448-6441
Mailing Address - Street 1:610 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-1533
Mailing Address - Country:US
Mailing Address - Phone:920-448-6405
Mailing Address - Fax:920-448-6449
Practice Address - Street 1:610 S BROADWAY
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-1533
Practice Address - Country:US
Practice Address - Phone:920-448-6405
Practice Address - Fax:920-448-6449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000081863Medicare PIN