Provider Demographics
NPI:1407548530
Name:RUSH COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:RUSH COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:DAUGHTERY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-932-1031
Mailing Address - Street 1:101 E 2ND ST RM 105
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1854
Mailing Address - Country:US
Mailing Address - Phone:765-932-3103
Mailing Address - Fax:
Practice Address - Street 1:101 E 2ND ST RM 105
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-1854
Practice Address - Country:US
Practice Address - Phone:765-932-3103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local