County of Scott
Organization Active NPI Public Health or Welfare Agency · Winchester, IL
NPI 1124171491 · NPPES record last updated Feb 11, 2013
Key facts
- NPI
- 1124171491
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- COUNTY OF SCOTT
- Practice address
- 335 W Cherry St
Winchester, IL 62694-1029 - Phone
- (217) 742-8203
- Fax
- (217) 742-8304
- NPI assigned
- Jan 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Steve Shireman
- Title
- Administrator
- Phone
- (217) 742-8203
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D1001789 | Scott County Health Department | Certificate of waiver | Jul 21, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051130000776 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 0345260766 | Practice locations: Winchester, IL |
National Provider Directory
Locations
335 W Cherry St
Winchester, IL 62694
Phone (217) 742-8203
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
335 W Cherry St
Winchester, IL 62694-1029
Mailing address
335 W Cherry St
Winchester, IL 62694-1029
Phone (217) 742-8203
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 240000171001 | Medicaid | IL |
Other providers in Winchester, IL
- Baker'S Pharmacy
- Bakers Pharmacy
- Community Unit School District #1
- Jill Bergstrom Cox
- Nicole Dorsey
- Paul Thomas Gilman
- Elizabeth Ann Grogan
- Mary Hall
All providers in Winchester, IL · Public Health or Welfare Agency in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.