Healthcare Provider Details

I. General information

NPI: 1518087444
Provider Name (Legal Business Name): CERRO GORDO COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2570 4TH ST SW SUITE #1
MASON CITY IA
50401-3435
US

IV. Provider business mailing address

2570 4TH ST SW STE 1
MASON CITY IA
50401-4665
US

V. Phone/Fax

Practice location:
  • Phone: 641-421-9300
  • Fax:
Mailing address:
  • Phone: 641-423-9304
  • Fax: 641-421-9350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. BRIAN HANFT
Title or Position: HEALTH DIRECTOR
Credential:
Phone: 641-421-9300