Healthcare Provider Details

I. General information

NPI: 1043202062
Provider Name (Legal Business Name): COUNTY OF TAYLOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 JEFFERSON ST STE 1
BEDFORD IA
50833-1300
US

IV. Provider business mailing address

405 JEFFERSON ST STE 1
BEDFORD IA
50833-1300
US

V. Phone/Fax

Practice location:
  • Phone: 712-523-3405
  • Fax: 712-523-3402
Mailing address:
  • Phone: 712-523-3405
  • Fax: 712-523-3402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateIA

VIII. Authorized Official

Name: JOAN E GALLAGHER
Title or Position: AGENCY ADMINISTRATOR
Credential:
Phone: 712-523-3405