Healthcare Provider Details

I. General information

NPI: 1104991314
Provider Name (Legal Business Name): COUNTY OF LINN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 6TH ST SE
CEDAR RAPIDS IA
52401-2464
US

IV. Provider business mailing address

501 13TH ST NW
CEDAR RAPIDS IA
52405-3747
US

V. Phone/Fax

Practice location:
  • Phone: 319-892-6000
  • Fax:
Mailing address:
  • Phone: 319-892-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0161745
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: PRAMOD DWIVEDI
Title or Position: HEALTH DIRECTOR
Credential:
Phone: 319-892-6000