Provider Demographics
NPI:1528215647
Name:SCOTLAND COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:SCOTLAND COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:LIN
Authorized Official - Last Name:KROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:660-465-7275
Mailing Address - Street 1:214 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:MO
Mailing Address - Zip Code:63555-1044
Mailing Address - Country:US
Mailing Address - Phone:660-465-7275
Mailing Address - Fax:
Practice Address - Street 1:214 W MADISON ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:MO
Practice Address - Zip Code:63555-1044
Practice Address - Country:US
Practice Address - Phone:660-465-7275
Practice Address - Fax:660-465-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO147-20251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO510563307Medicaid