Provider Demographics
NPI:1821126327
Name:COUNTY OF HOUGHTON
Entity Type:Organization
Organization Name:COUNTY OF HOUGHTON
Other - Org Name:WESTERN U.P. DISTRICT HEALTH DEPARTMENT & SUPERIOR HOME NURSING & HOSP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH OFFICER AND ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHRYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-482-7382
Mailing Address - Street 1:540 DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930-2031
Mailing Address - Country:US
Mailing Address - Phone:906-482-7382
Mailing Address - Fax:906-482-9410
Practice Address - Street 1:303 BARAGA AVE
Practice Address - Street 2:
Practice Address - City:LANSE
Practice Address - State:MI
Practice Address - Zip Code:49946-1409
Practice Address - Country:US
Practice Address - Phone:906-542-6142
Practice Address - Fax:906-524-6144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI773018671Medicaid
MI=========OtherIMMUNIZATION UPHP