Provider Demographics
NPI:1255468625
Name:PERRY COUNTY OHIO
Entity Type:Organization
Organization Name:PERRY COUNTY OHIO
Other - Org Name:PERRY COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEROLPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-342-5179
Mailing Address - Street 1:409 LINCOLN PARK DRIVE ; P.O. BOX 230
Mailing Address - Street 2:
Mailing Address - City:NEW LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43764-0230
Mailing Address - Country:US
Mailing Address - Phone:740-342-5179
Mailing Address - Fax:740-342-5540
Practice Address - Street 1:212 S MAIN ST LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:NEW LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:43764-1369
Practice Address - Country:US
Practice Address - Phone:740-342-5179
Practice Address - Fax:740-342-5540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0652182Medicaid
OHFV90631Medicare PIN