Provider Demographics
NPI:1841331501
Name:SALINE COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:SALINE COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:V
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-886-3434
Mailing Address - Street 1:1825 ATCHISON AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MO
Mailing Address - Zip Code:65340-9752
Mailing Address - Country:US
Mailing Address - Phone:660-886-3434
Mailing Address - Fax:660-886-6676
Practice Address - Street 1:1825 ATCHISON AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-9752
Practice Address - Country:US
Practice Address - Phone:660-886-3434
Practice Address - Fax:660-886-6676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002023836251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207425307Medicaid
MO249690900Medicaid
MO512174301Medicaid