Provider Demographics
NPI:1922383322
Name:FULTON COUNTY
Entity Type:Organization
Organization Name:FULTON COUNTY
Other - Org Name:FULTON COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:ORICKO
Authorized Official - Suffix:
Authorized Official - Credentials:MSEPH
Authorized Official - Phone:419-337-0915
Mailing Address - Street 1:606 S SHOOP AVE
Mailing Address - Street 2:
Mailing Address - City:WAUSEON
Mailing Address - State:OH
Mailing Address - Zip Code:43567-1712
Mailing Address - Country:US
Mailing Address - Phone:419-337-0915
Mailing Address - Fax:419-337-0561
Practice Address - Street 1:606 S SHOOP AVE
Practice Address - Street 2:
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-1712
Practice Address - Country:US
Practice Address - Phone:419-337-0915
Practice Address - Fax:419-337-0561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2023251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0724176Medicaid