Provider Demographics
NPI:1962701185
Name:MARSHALL COUNTY INDIANA
Entity type:Organization
Organization Name:MARSHALL COUNTY INDIANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR HEALTH DEPARTMENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:STINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-935-8565
Mailing Address - Street 1:510 W ADAMS ST STE GL30
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:IN
Mailing Address - Zip Code:46563-1784
Mailing Address - Country:US
Mailing Address - Phone:574-935-8565
Mailing Address - Fax:574-936-9247
Practice Address - Street 1:510 W ADAMS ST STE GL30
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:IN
Practice Address - Zip Code:46563-1784
Practice Address - Country:US
Practice Address - Phone:574-935-8565
Practice Address - Fax:574-936-9247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201024050AMedicaid