Provider Demographics
NPI:1235266354
Name:MADISON COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MADISON COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-641-9524
Mailing Address - Street 1:206 E 9TH STREET
Mailing Address - Street 2:MADISON COUNTY HEALTH DEPARTMENT
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016-1680
Mailing Address - Country:US
Mailing Address - Phone:765-646-9206
Mailing Address - Fax:765-646-9208
Practice Address - Street 1:206 E 9TH STREET
Practice Address - Street 2:MADISON COUNTY HEALTH DEPARTMENT
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-1680
Practice Address - Country:US
Practice Address - Phone:765-646-9206
Practice Address - Fax:765-646-9208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare