Provider Demographics
NPI:1407271810
Name:WAYNE COUNTY TREASURY
Entity Type:Organization
Organization Name:WAYNE COUNTY TREASURY
Other - Org Name:WAYNE COUNTY PUBLIC HEALTH NURSING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RN/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-872-1167
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IA
Mailing Address - Zip Code:50060-0102
Mailing Address - Country:US
Mailing Address - Phone:641-872-1167
Mailing Address - Fax:641-872-1174
Practice Address - Street 1:100 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IA
Practice Address - Zip Code:50060-1724
Practice Address - Country:US
Practice Address - Phone:641-872-1167
Practice Address - Fax:641-872-1174
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAYNE COUNTY TREASURY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-21
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0670455Medicaid
IA0670455Medicaid