Healthcare Provider Details

I. General information

NPI: 1962584409
Provider Name (Legal Business Name): COUNTY OF CHICKASAW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 04/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E PROSPECT ST
NEW HAMPTON IA
50659-1429
US

IV. Provider business mailing address

260 E PROSPECT ST PO BOX 355
NEW HAMPTON IA
50659-1429
US

V. Phone/Fax

Practice location:
  • Phone: 641-394-4053
  • Fax: 641-394-5814
Mailing address:
  • Phone: 641-394-4053
  • Fax: 641-394-5814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KATHY BABCOCK
Title or Position: ADMINISTRATOR
Credential:
Phone: 641-394-4053