Provider Demographics
NPI:1346395092
Name:COUNTY OF WARREN
Entity Type:Organization
Organization Name:COUNTY OF WARREN
Other - Org Name:WARREN CO HEALTH DEPT
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-456-7474
Mailing Address - Street 1:104 W BOONESLICK RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:WARRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63383-1998
Mailing Address - Country:US
Mailing Address - Phone:636-456-7474
Mailing Address - Fax:636-456-4966
Practice Address - Street 1:104 W BOONESLICK RD
Practice Address - Street 2:SUITE H
Practice Address - City:WARRENTON
Practice Address - State:MO
Practice Address - Zip Code:63383-1998
Practice Address - Country:US
Practice Address - Phone:636-456-7474
Practice Address - Fax:636-456-4966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000045039Medicare UPIN