Provider Demographics
NPI:1144357286
Name:MACON COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:MACON COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:R
Authorized Official - Last Name:RUSHTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:660-385-4711
Mailing Address - Street 1:503 N MISSOURI ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:MO
Mailing Address - Zip Code:63552-1751
Mailing Address - Country:US
Mailing Address - Phone:660-385-4711
Mailing Address - Fax:660-385-2014
Practice Address - Street 1:503 N MISSOURI ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:MO
Practice Address - Zip Code:63552-1751
Practice Address - Country:US
Practice Address - Phone:660-385-4711
Practice Address - Fax:660-385-2014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00331849Medicare ID - Type UnspecifiedPALMETTO GBA-RAILROAD