Healthcare Provider Details

I. General information

NPI: 1386720563
Provider Name (Legal Business Name): COUNTY OF VAN BUREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 02/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 BROAD ST COURTHOUSE
KEOSAUQUA IA
52565-0514
US

IV. Provider business mailing address

PO BOX 514 905 BROAD ST
KEOSAUQUA IA
52565-0514
US

V. Phone/Fax

Practice location:
  • Phone: 319-293-3431
  • Fax: 319-293-3609
Mailing address:
  • Phone: 319-293-3431
  • Fax: 319-293-3609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LINDEE J THOMAS
Title or Position: NURSE ADMINISTRATOR
Credential: RN
Phone: 319-293-3431