Organization
CLAY COUNTY HEALTH DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF ALAN WORKMAN (ADMINISTRATOR)
(618) 662-4406
Entity
Organization
Contact information
Practice address
601 E 12TH ST, FLORA, IL 62839-2335
(618) 662-4406
(618) 662-2801
Mailing address
601 E 12TH ST, FLORA, IL 62839-2335
(618) 662-4406
(618) 662-2801
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01332005
BC/BS PROVIDER ID-IMM
IL
01
—
01332009
HOME DIALYSIS RN PROVIDER
IL
Enumeration date
11/03/2006
Last updated
08/22/2020
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