Provider Demographics
NPI:1316974595
Name:COUNTY OF MORGAN HEALTH DEPT
Entity type:Organization
Organization Name:COUNTY OF MORGAN HEALTH DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAINTER
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:217-245-5111
Mailing Address - Street 1:425 E STATE STREET
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650-2125
Mailing Address - Country:US
Mailing Address - Phone:217-245-5111
Mailing Address - Fax:217-243-4773
Practice Address - Street 1:425 E STATE STREET
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-2125
Practice Address - Country:US
Practice Address - Phone:217-245-5111
Practice Address - Fax:217-243-4773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========Medicaid
IL=========001Medicaid