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General NPI Number Information
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NPI Number | 1912970401
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Entity Type | Organization
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Legal Business Name | LUCAS COUNTY HEALTH CENTER
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 12/16/2020
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Provider Practice Location Address
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Address Line | 1200 N 7TH ST
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City | CHARITON
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State | IA
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Zip | 50049-1210
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Country | US
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Telephone | 641-774-3000
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Fax | 641-774-3207
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Provider Business Mailing Address
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Address Line | 1200 N 7TH ST
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City | CHARITON
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State | IA
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Zip | 50049-1210
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Country | US
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Telephone | 641-774-3000
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Fax | 641-774-3207
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | LORI JOHNSON
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Credential |
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Telephone | 641-774-3360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 16Z341
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License Number State | IA
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