Healthcare Provider Details

I. General information

NPI: 1437133998
Provider Name (Legal Business Name): LEE COUNTY AUDITOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 JOHN BENNETT DRIVE
FORT MADISON IA
52627-4036
US

IV. Provider business mailing address

PO BOX 1426
FORT MADISON IA
52627-4036
US

V. Phone/Fax

Practice location:
  • Phone: 319-372-5225
  • Fax: 319-372-4374
Mailing address:
  • Phone: 319-372-5225
  • Fax: 319-372-4374

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

VII. Legacy identifiers

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

# 1
Identifier0615179
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer
# 2
Identifier0221069
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer
# 3
Identifier0187351
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer
# 4
Identifier0225920
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer
# 5
Identifier0670554
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer
# 6
Identifier67055
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerWELLMARK HOME CARE

VIII. Authorized Official

Name: MICHELE D ROSS
Title or Position: ADMINISTRATOR
Credential:
Phone: 319-372-5225