NPI:
1245216241
Provider Name:
FULTON COUNTY HEALTH DEPARTMENT
Doing Business As: FULTON COUNTY HEALTH DEPARTMENT
Classification:
Clinic/Center - 261QP0905X
Entity Type:
Organization
Specialization: Public Health, State or Local
CLIA Number: 14D0858054
Address:
700 EAST OAK STREET
CANTON, IL
ZIP 61520
Phone:
(309) 647-1134
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FULTON COUNTY HEALTH DEPARTMENT is a public health and state or local clinic center in Canton, IL. FULTON COUNTY HEALTH DEPARTMENT NPI is 1245216241. The provider is registered as an organization entity type.
The provider Is Doing Business As Fulton County Health Department.
The provider's business location address is:
700 EAST OAK STREET
CANTON, IL
ZIP 61520
Phone: (309) 647-1134
Fax: (309) 647-9545
The provider's authorized official is Damon Scott Roberson .
The authorized official title is Administrator and has the following contact phone number (309) 647-1134.
The CLIA number assigned to this NPI record is 14D0858054 - other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 12/21/2005 and was last updated on 4/22/2015.