Provider Demographics
NPI:1528065307
Name:NOBLE COUNTY
Entity type:Organization
Organization Name:NOBLE COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:E
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:RS, MPH
Authorized Official - Phone:740-732-4958
Mailing Address - Street 1:44069 MARIETTA RD
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43724-9124
Mailing Address - Country:US
Mailing Address - Phone:740-732-4958
Mailing Address - Fax:740-732-5043
Practice Address - Street 1:44069 MARIETTA RD
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:OH
Practice Address - Zip Code:43724-9124
Practice Address - Country:US
Practice Address - Phone:740-732-4958
Practice Address - Fax:740-732-5043
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOBLE COUNTY HEALTH DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0021336Medicaid
OH0021336Medicaid