=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851341952
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COUNTY OF IOWA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2006
-----------------------------------------------------
Last Update Date | 12/30/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 303 W CHAPEL ST STE 2200
-----------------------------------------------------
City | DODGEVILLE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53533-1314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-930-9870
-----------------------------------------------------
Fax | 608-937-0501
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 303 W CHAPEL ST STE 2200
-----------------------------------------------------
City | DODGEVILLE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53533-1314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-930-9870
-----------------------------------------------------
Fax | 608-937-0501
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | RN, BSN
-----------------------------------------------------
Name | JUNE ELLEN MEUDT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 608-930-9870
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------