# CHAMPAIGN COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285754994
- **Authorized official:** STACEY A THOMAS BSN RN (DIRECTOR OF NURSING)
- **Authorized official phone:** (937) 484-1619

## Contact information

- **Practice address:** 1512 S US HIGHWAY 68, SUITE Q100, URBANA, OH 43078-9198
- **Practice address phone:** (937) 484-1605
- **Practice address fax:** (937) 484-1622
- **Mailing address:** 1512 S US HIGHWAY 68, SUITE Q100, URBANA, OH 43078-9198
- **Mailing address phone:** (937) 484-1605
- **Mailing address fax:** (937) 484-1622

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | 034599 | OH | Yes |

## Other

- **Enumeration date:** 03/29/2007
- **Last updated:** 10/30/2017