Provider Demographics
NPI:1760715346
Name:RUSH CO. HEALTH DEPT.
Entity Type:Organization
Organization Name:RUSH CO. HEALTH DEPT.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-932-3103
Mailing Address - Street 1:101 E 2ND ST
Mailing Address - Street 2:ROOM 105, COURT HOUSE
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-1871
Mailing Address - Country:US
Mailing Address - Phone:765-932-3103
Mailing Address - Fax:765-938-2604
Practice Address - Street 1:101 E 2ND ST
Practice Address - Street 2:ROOM 105, COURT HOUSE
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-1871
Practice Address - Country:US
Practice Address - Phone:765-932-3103
Practice Address - Fax:765-938-2604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01015227A251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare