Provider Demographics
NPI:1871583617
Name:DEFIANCE COUNTY GENERAL HEALTH DISTRICT
Entity type:Organization
Organization Name:DEFIANCE COUNTY GENERAL HEALTH DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN,MPH
Authorized Official - Phone:439-784-3818
Mailing Address - Street 1:1300 E 2ND ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-2482
Mailing Address - Country:US
Mailing Address - Phone:419-784-3818
Mailing Address - Fax:419-782-4979
Practice Address - Street 1:1300 E 2ND ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-2482
Practice Address - Country:US
Practice Address - Phone:419-784-3818
Practice Address - Fax:419-782-4979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH733178OtherBUCKEYE COMMUNITY
OH0252551Medicaid
OH06328OtherPARAMOUNT
OH733178OtherBUCKEYE COMMUNITY