Provider Demographics
NPI:1225026057
Name:COUNTY OF MONROE
Entity type:Organization
Organization Name:COUNTY OF MONROE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-240-7804
Mailing Address - Street 1:2353 S CUSTER RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-5047
Mailing Address - Country:US
Mailing Address - Phone:734-240-7800
Mailing Address - Fax:734-240-7815
Practice Address - Street 1:2353 S CUSTER RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-5047
Practice Address - Country:US
Practice Address - Phone:734-240-7800
Practice Address - Fax:734-240-7815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI0E81000Medicare PIN