Provider Demographics
NPI:1497787030
Name:RALLS COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:RALLS COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAEKAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILER
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:573-985-7121
Mailing Address - Street 1:405 W. FIRST ST.
Mailing Address - Street 2:PO BOX 434
Mailing Address - City:NEW LONDON
Mailing Address - State:MO
Mailing Address - Zip Code:63459
Mailing Address - Country:US
Mailing Address - Phone:573-985-7121
Mailing Address - Fax:573-985-1531
Practice Address - Street 1:405 W. FIRST ST.
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:MO
Practice Address - Zip Code:63459
Practice Address - Country:US
Practice Address - Phone:573-985-7121
Practice Address - Fax:573-985-1531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO580620102Medicaid
MO280620105Medicaid
MO260620109Medicaid
MO510620107Medicaid