Provider Demographics
NPI:1326011982
Name:WAKULLA COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:WAKULLA COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:LAVERNE
Authorized Official - Last Name:YEOMANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-926-3591
Mailing Address - Street 1:48 OAK ST
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32327-2085
Mailing Address - Country:US
Mailing Address - Phone:850-926-3591
Mailing Address - Fax:850-926-2178
Practice Address - Street 1:48 OAK ST
Practice Address - Street 2:
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-2085
Practice Address - Country:US
Practice Address - Phone:850-926-3591
Practice Address - Fax:850-926-2178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL47-00-040325-52C251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare