1801879440 NPI number — COUNTY OF FLOYD

Table of content: (NPI 1801879440)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801879440 NPI number — COUNTY OF FLOYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF FLOYD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FLOYD COUNTY PUBLIC HEALTH HOME HEALTH CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801879440
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1003 GILBERT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLES CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50616-2637
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-257-6111
Provider Business Mailing Address Fax Number:
641-257-6146

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1003 GILBERT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLES CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50616-2637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-257-6111
Provider Business Practice Location Address Fax Number:
641-257-6146
Provider Enumeration Date:
11/29/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KAMM
Authorized Official First Name:
DOUGLAS
Authorized Official Middle Name:
A
Authorized Official Title or Position:
FLOYD CO BOARD OF SUPR
Authorized Official Telephone Number:
641-257-6129

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0671602 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 67051 . This is a "WELLMARK BCBS OF IOWA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".