Provider Demographics
NPI:1548384670
Name:BARRY COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:BARRY COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-847-2114
Mailing Address - Street 1:65 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CASSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65625-9400
Mailing Address - Country:US
Mailing Address - Phone:417-847-2114
Mailing Address - Fax:417-847-2116
Practice Address - Street 1:65 MAIN ST
Practice Address - Street 2:
Practice Address - City:CASSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65625-9400
Practice Address - Country:US
Practice Address - Phone:417-847-2114
Practice Address - Fax:417-847-2116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO512182502Medicaid
MO000045033Medicare ID - Type Unspecified
MO512182502Medicaid