Provider Demographics
NPI:1689877359
Name:NEW MADRID COUNTY HEALTH DEPT
Entity Type:Organization
Organization Name:NEW MADRID COUNTY HEALTH DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:F
Authorized Official - Last Name:DEES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-748-5541
Mailing Address - Street 1:406 US HIGHWAY 61
Mailing Address - Street 2:
Mailing Address - City:NEW MADRID
Mailing Address - State:MO
Mailing Address - Zip Code:63869-1642
Mailing Address - Country:US
Mailing Address - Phone:573-748-5541
Mailing Address - Fax:573-748-5996
Practice Address - Street 1:406 US HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:NEW MADRID
Practice Address - State:MO
Practice Address - Zip Code:63869-1642
Practice Address - Country:US
Practice Address - Phone:573-748-5541
Practice Address - Fax:573-748-5996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO428334304Medicaid
MO511175002Medicaid
MO511175002Medicaid