Provider Demographics
NPI:1144207960
Name:CITY OF COLUMBIA-BOONE COUNTY HEALTH DEPT
Entity Type:Organization
Organization Name:CITY OF COLUMBIA-BOONE COUNTY HEALTH DEPT
Other - Org Name:COLUMBIA-BOONE COUNTY HEALTH DEPT
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-874-7355
Mailing Address - Street 1:1005 W WORLEY ST
Mailing Address - Street 2:P O BOX 6015
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2037
Mailing Address - Country:US
Mailing Address - Phone:573-874-7355
Mailing Address - Fax:573-874-7758
Practice Address - Street 1:1005 W WORLEY ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2037
Practice Address - Country:US
Practice Address - Phone:573-874-7355
Practice Address - Fax:573-874-7758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7J47251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2644Medicaid