Provider Demographics
NPI:1104887801
Name:CASS COUNTY PUBLIC HEALTH DEPARTMENT
Entity type:Organization
Organization Name:CASS COUNTY PUBLIC HEALTH DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:217-452-3057
Mailing Address - Street 1:331 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA
Mailing Address - State:IL
Mailing Address - Zip Code:62691-1519
Mailing Address - Country:US
Mailing Address - Phone:217-452-3057
Mailing Address - Fax:217-452-7245
Practice Address - Street 1:331 S MAIN ST
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:IL
Practice Address - Zip Code:62691-1519
Practice Address - Country:US
Practice Address - Phone:217-452-3057
Practice Address - Fax:217-452-7245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9885OtherBLUE CROSS BLUE SHIELD
IL147221Medicare ID - Type UnspecifiedPROVIDER NUMBER
IL=========004Medicaid