MEDICARE: WARREN COUNTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332U00000X	Home Delivered Meals	0165878	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265638225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARREN COUNTY

Provider Business Mailing Address
First Line	:	301 N BUXTON ST STE 202
Second Line	:
City	:	INDIANOLA
State	:	IA
Zip	:	50125-1801
Country	:	US
Telephone Number	:	515-961-1003
Fax Number	:	515-961-1013

Provider Business Practice Location Address
First Line	:	301 N BUXTON ST STE 202
Second Line	:
City	:	INDIANOLA
State	:	IA
Zip	:	50125-1801
Country	:	US
Telephone Number	:	515-961-1003
Fax Number	:	515-961-1013

Authorized Official
Title or Position	:	NUTRITION PROJECT MANAGER
Name	:	MS. LEORA F. SCHURMAN
Credential	:
Telephone Number	:	515-961-1003

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	08/22/2020

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Directions to “WARREN COUNTY ” Practice Location

Language	Start Address	Practice Location

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