Provider Demographics
NPI:1194879320
Name:DARKE COUNTY GENERAL HEALTH DISTRICT
Entity type:Organization
Organization Name:DARKE COUNTY GENERAL HEALTH DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:937-548-4196
Mailing Address - Street 1:300 GARST AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-2389
Mailing Address - Country:US
Mailing Address - Phone:937-548-4196
Mailing Address - Fax:937-548-9128
Practice Address - Street 1:300 GARST AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-2389
Practice Address - Country:US
Practice Address - Phone:937-548-4196
Practice Address - Fax:937-548-9128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHFV90741Medicare PIN