Provider Demographics
NPI:1821216292
Name:SHELBY COUNTY HEALTH DEPT & HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:SHELBY COUNTY HEALTH DEPT & HOME HEALTH AGENCY
Other - Org Name:SHELBY COUNTY HEALTH DEPARTMENT AND HOME HEALTH AGENCY
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THRASHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-633-2353
Mailing Address - Street 1:PO BOX 240
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63469-0240
Mailing Address - Country:US
Mailing Address - Phone:573-633-2353
Mailing Address - Fax:573-633-2323
Practice Address - Street 1:700 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63469-1422
Practice Address - Country:US
Practice Address - Phone:573-633-2353
Practice Address - Fax:573-633-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO512051301Medicaid