Provider Demographics
NPI:1356466098
Name:COUNTY OF JACKSON
Entity Type:Organization
Organization Name:COUNTY OF JACKSON
Other - Org Name:JACKSON COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ASTON
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:740-286-5094
Mailing Address - Street 1:200 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640-1716
Mailing Address - Country:US
Mailing Address - Phone:740-286-5094
Mailing Address - Fax:740-286-8809
Practice Address - Street 1:200 E MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-1716
Practice Address - Country:US
Practice Address - Phone:740-286-5094
Practice Address - Fax:740-286-8809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH948007OtherWORKMAN'S COMPENSATION
OH0836439Medicaid
OH=========OtherFEDERAL TAX ID NUMBER