MEDICARE: COUNTY OF DAKOTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency
2	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1679988984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF DAKOTA

Provider Business Mailing Address
First Line	:	PO BOX 155
Second Line	:
City	:	DAKOTA CITY
State	:	NE
Zip	:	68731-0155
Country	:	US
Telephone Number	:	402-987-2164
Fax Number	:	402-987-2163

Provider Business Practice Location Address
First Line	:	1601 BROADWAY ST
Second Line	:
City	:	DAKOTA CITY
State	:	NE
Zip	:	68731-5065
Country	:	US
Telephone Number	:	402-987-2164
Fax Number	:	402-987-2163

Authorized Official
Title or Position	:	BOARD CHAIR
Name	:	WILLIAM B RHODE
Credential	:
Telephone Number	:	712-898-0852

Provider Enumeration Date	:	06/25/2014
Last Update Date	:	06/25/2014

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1639368723 — COUNTY OF DAKOTA
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Directions to “COUNTY OF DAKOTA ” Practice Location

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