Provider Demographics
NPI:1346242484
Name:HOWARD COUNTY COMMISSION
Entity Type:Organization
Organization Name:HOWARD COUNTY COMMISSION
Other - Org Name:HOWARD COUNTY PUBLIC HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RN/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-248-3100
Mailing Address - Street 1:600 W MORRISON ST
Mailing Address - Street 2:STE 7
Mailing Address - City:FAYETTE
Mailing Address - State:MO
Mailing Address - Zip Code:65248-1075
Mailing Address - Country:US
Mailing Address - Phone:660-248-3100
Mailing Address - Fax:660-248-3275
Practice Address - Street 1:600 W MORRISON ST
Practice Address - Street 2:STE 7
Practice Address - City:FAYETTE
Practice Address - State:MO
Practice Address - Zip Code:65248-1075
Practice Address - Country:US
Practice Address - Phone:660-248-3100
Practice Address - Fax:660-248-3275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO511996704Medicaid
MO511996704Medicaid