Provider Demographics
NPI:1225229685
Name:WABASH COUNTY AUDITOR
Entity Type:Organization
Organization Name:WABASH COUNTY AUDITOR
Other - Org Name:WABASH COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:RUDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-563-0661
Mailing Address - Street 1:89 W HILL ST
Mailing Address - Street 2:WABASH COUNTY HEALTH DEPARTMENT
Mailing Address - City:WABASH
Mailing Address - State:IN
Mailing Address - Zip Code:46992-3160
Mailing Address - Country:US
Mailing Address - Phone:260-563-0661
Mailing Address - Fax:260-563-6082
Practice Address - Street 1:89 W HILL ST
Practice Address - Street 2:WABASH COUNTY HEALTH DEPARTMENT
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992-3160
Practice Address - Country:US
Practice Address - Phone:260-563-0661
Practice Address - Fax:260-563-6082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INP00085251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN=========OtherEIN