Provider Demographics
NPI:1992793517
Name:ADAIR COUNTY HEALTH DEPT
Entity type:Organization
Organization Name:ADAIR COUNTY HEALTH DEPT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:LEBARON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-665-8491
Mailing Address - Street 1:1001 S JAMISON ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-3941
Mailing Address - Country:US
Mailing Address - Phone:660-665-8491
Mailing Address - Fax:660-627-2913
Practice Address - Street 1:1001 S JAMISON ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-3941
Practice Address - Country:US
Practice Address - Phone:660-665-8491
Practice Address - Fax:660-627-2913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO125-20251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO267191Medicare ID - Type Unspecified
MO581881505Medicare ID - Type Unspecified