Provider Demographics
NPI:1508233727
Name:DOH
Entity Type:Organization
Organization Name:DOH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:ERRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-342-0907
Mailing Address - Street 1:1255 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:FL
Mailing Address - Zip Code:32344-1128
Mailing Address - Country:US
Mailing Address - Phone:850-342-0907
Mailing Address - Fax:850-342-0123
Practice Address - Street 1:1255 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:FL
Practice Address - Zip Code:32344-1128
Practice Address - Country:US
Practice Address - Phone:850-342-0907
Practice Address - Fax:850-342-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5173799251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare