County of Edgar
Organization Active NPI Public Health or Welfare Agency · Paris, IL
NPI 1376533513 · NPPES record last updated Apr 4, 2011
Key facts
- NPI
- 1376533513
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- COUNTY OF EDGAR
- Practice address
- 502 Shaw Ave
Paris, IL 61944-2352 - Phone
- (217) 465-2212
- Fax
- (217) 465-1121
- NPI assigned
- Oct 27, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Eddy MC Farland, DENTAL CLINIC
- Title
- Administrator
- Phone
- (217) 465-2212
Practitioners 5
-
Lori A Cline, RDH, PHDH
-
Monica Y Dunn, RDH, PHDH
-
Lynette Suzanne Isbell, RN, IBCLC
-
Charla J McGuire, RDH; PHDH
-
Kimberly A Newell, RDH, PHDH
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0915394 | Edgar County Health Department | Certificate of waiver | May 27, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110408000374 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 2860305299 | Practice locations: Paris, IL |
National Provider Directory
Locations
502 Shaw Ave
Paris, IL 61944
Phone (217) 465-2212
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
502 Shaw Ave
Paris, IL 61944-2352
Mailing address
502 Shaw Ave
Paris, IL 61944-2352
Phone (217) 465-2212
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103024 | Medicaid | IL |
Other providers in Paris, IL
- Jacqueline Ann Coffman
- Jessica Collins
- Community Living Options Inc
- Community Living Options Inc
- Jennifer Michelle Coslet
- Yaniv Cozacov
- Casey Lynn Craig
- Chandra Cravens
- Michelle Creech
- Jennifer Crockett
All providers in Paris, 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 Apr 4, 2011. 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.