Healthcare Provider Details

I. General information

NPI: 1285622720
Provider Name (Legal Business Name): COUNTY OF KEOKUK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S. MAIN ST.
SIGOURNEY IA
52591-1499
US

IV. Provider business mailing address

101 S MAIN ST COURTHOUSE
SIGOURNEY IA
52591-1419
US

V. Phone/Fax

Practice location:
  • Phone: 641-622-3575
  • Fax: 641-622-1052
Mailing address:
  • Phone: 641-622-3575
  • Fax: 641-622-1052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
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
Identifier1670885
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerVA
# 2
Identifier67088
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerWELLMARK
# 3
Identifier0670885
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: ALLIE JO HELMUTH
Title or Position: DIRECTOR
Credential:
Phone: 641-622-3575