Provider Demographics
NPI:1376679233
Name:CITY OF DE PERE
Entity Type:Organization
Organization Name:CITY OF DE PERE
Other - Org Name:HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:CLERK TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-339-4050
Mailing Address - Street 1:335 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-2526
Mailing Address - Country:US
Mailing Address - Phone:920-339-4050
Mailing Address - Fax:920-339-2745
Practice Address - Street 1:335 S BROADWAY
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-2526
Practice Address - Country:US
Practice Address - Phone:920-339-4050
Practice Address - Fax:920-339-2745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare