Provider Demographics
NPI:1568442556
Name:HENRY COUNTY AUDITORS OFFICE
Entity type:Organization
Organization Name:HENRY COUNTY AUDITORS OFFICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT BOARD OF HEALTH
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-599-5612
Mailing Address - Street 1:1843 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-9243
Mailing Address - Country:US
Mailing Address - Phone:419-599-5612
Mailing Address - Fax:419-599-1714
Practice Address - Street 1:1843 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-9243
Practice Address - Country:US
Practice Address - Phone:419-599-5612
Practice Address - Fax:419-599-1714
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENRY COUNTY AUDITORS OFFICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-18
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0121979Medicaid
000000157603OtherANTHEM
=========013OtherMEDICAL MUTUAL
=========013OtherMEDICAL MUTUAL