Provider Demographics
NPI:1144792052
Name:MADISON COUNTY RURAL HEALTH COUNCIL, INC.
Entity Type:Organization
Organization Name:MADISON COUNTY RURAL HEALTH COUNCIL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-313-4399
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:CAZENOVIA
Mailing Address - State:NY
Mailing Address - Zip Code:13035-0430
Mailing Address - Country:US
Mailing Address - Phone:315-313-4399
Mailing Address - Fax:
Practice Address - Street 1:2662 US ROUTE 20 STE 1
Practice Address - Street 2:
Practice Address - City:CAZENOVIA
Practice Address - State:NY
Practice Address - Zip Code:13035-9565
Practice Address - Country:US
Practice Address - Phone:607-316-2175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare