Provider Demographics
NPI:1871591941
Name:BOND COUNTY TREASURER
Entity type:Organization
Organization Name:BOND COUNTY TREASURER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EIFERT
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:618-664-5020
Mailing Address - Street 1:1520 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62246-2618
Mailing Address - Country:US
Mailing Address - Phone:618-664-5020
Mailing Address - Fax:618-664-9682
Practice Address - Street 1:1520 S 4TH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:IL
Practice Address - Zip Code:62246-2618
Practice Address - Country:US
Practice Address - Phone:618-664-5020
Practice Address - Fax:618-664-9682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1000025251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL147023Medicare ID - Type UnspecifiedBOND CO. HEALTH DEPT.