Provider Demographics
NPI:1548320468
Name:MORROW COUNTY
Entity type:Organization
Organization Name:MORROW COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:419-947-1545
Mailing Address - Street 1:619 W MARION RD
Mailing Address - Street 2:SUITE B-143
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-1489
Mailing Address - Country:US
Mailing Address - Phone:419-947-1545
Mailing Address - Fax:419-946-6807
Practice Address - Street 1:619 W MARION RD
Practice Address - Street 2:SUITE B-143
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-1489
Practice Address - Country:US
Practice Address - Phone:419-947-1545
Practice Address - Fax:419-946-6807
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORROW COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-11
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36D0655857251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0655456Medicaid
OH9256921Medicare PIN