Provider Demographics
NPI:1467516641
Name:CLARK CO. HEALTH DEPT.
Entity Type:Organization
Organization Name:CLARK CO. HEALTH DEPT.
Other - Org Name:CLARK CO. HEALTH DEPT.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MEYER III
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-282-7521
Mailing Address - Street 1:1301 AKERS AVE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3720
Mailing Address - Country:US
Mailing Address - Phone:812-288-2706
Mailing Address - Fax:812-288-1474
Practice Address - Street 1:1403 SPRING ST
Practice Address - Street 2:#200
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3736
Practice Address - Country:US
Practice Address - Phone:812-288-2706
Practice Address - Fax:812-288-1474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100461960Medicare UPIN