Provider Demographics
NPI:1063708642
Name:SENECA COUNTY GENERAL HEALTH DISTRICT
Entity type:Organization
Organization Name:SENECA COUNTY GENERAL HEALTH DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BROADHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:419-447-3691
Mailing Address - Street 1:71 S WASHINGTON ST
Mailing Address - Street 2:SUITE 1102
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-2357
Mailing Address - Country:US
Mailing Address - Phone:419-447-3691
Mailing Address - Fax:419-448-5782
Practice Address - Street 1:71 S WASHINGTON ST
Practice Address - Street 2:SUITE 1102
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-2357
Practice Address - Country:US
Practice Address - Phone:419-447-3691
Practice Address - Fax:419-448-5782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0029589Medicaid