Provider Demographics
NPI:1548464050
Name:RUSK COUNTY PUBLIC HEALTH DEPARTMENT
Entity type:Organization
Organization Name:RUSK COUNTY PUBLIC HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER PH SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:BOLES
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:715-532-2299
Mailing Address - Street 1:311 MINER AVE E
Mailing Address - Street 2:C220
Mailing Address - City:LADYSMITH
Mailing Address - State:WI
Mailing Address - Zip Code:54848-2862
Mailing Address - Country:US
Mailing Address - Phone:715-532-2299
Mailing Address - Fax:715-532-2217
Practice Address - Street 1:311 MINER AVE E
Practice Address - Street 2:C220
Practice Address - City:LADYSMITH
Practice Address - State:WI
Practice Address - Zip Code:54848-2862
Practice Address - Country:US
Practice Address - Phone:715-532-2299
Practice Address - Fax:715-532-2217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI54251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41220700Medicaid
WI42008700Medicaid
WI41854800Medicaid
WI44012700Medicaid