Clay County Health Department
Organization Active NPI Public Health or Welfare Agency · Flora, IL
NPI 1700035201 · NPPES record last updated Sep 9, 2008
Key facts
- NPI
- 1700035201
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- CLAY COUNTY HEALTH DEPARTMENT
- Practice address
- 601 E 12TH St
Flora, IL 62839-2335 - Phone
- (618) 662-4406
- Fax
- (618) 662-2801
- NPI assigned
- Sep 9, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Jeffrey A Workman
- Title
- Administrator
- Phone
- (618) 662-4406
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Clay Home Health Services |
Home health agency | 5% Or Greater Direct Ownership Interest Operational/Managerial Control |
Dec 29, 1966 Dec 18, 1967 |
| Clay County Health Department Hospice |
Hospice | 5% Or Greater Direct Ownership Interest (100%) | Feb 11, 2003 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090324000364 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 4082524301 | Practice locations: Flora, IL |
National Provider Directory
- Tax ID family
- Clay County HLTH Department
Locations
601 E 12th St
Flora, IL 62839
Phone (618) 403-5166
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
601 E 12TH St
Flora, IL 62839-2335
Mailing address
601 E 12TH St
Flora, IL 62839-2335
Phone (618) 662-4406
Other providers in Flora, IL
- Champion Fitness, Inc
- Christopher Greater Area Rural Health Planning Corp
- Cila Corporation
- Clay County Chiropractic Inc
- Clay County Health Department
- Clay County Health Department
- Clay County Health Dept
- Clay County Horizon Center
- Clay County Hospital
- Clay County Rehabilitation Center, Inc.
All providers in Flora, 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 Sep 9, 2008. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.