1275675290 NPI number — TOWN OF SHELBY

Table of content: (NPI 1275675290)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275675290 NPI number — TOWN OF SHELBY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF SHELBY
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:
Provider Other Organization Name Type Code:
6
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:
1275675290
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 186
Provider Second Line Business Mailing Address:
419 EAST STREET
Provider Business Mailing Address City Name:
SHELBY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
51570
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
712-544-2404
Provider Business Mailing Address Fax Number:
712-544-2703

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
402 CENTER ST
Provider Second Line Business Practice Location Address:
BOX #6
Provider Business Practice Location Address City Name:
SHELBY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51570-3400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-544-2400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MARTIN
Authorized Official First Name:
CHRISTIE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CITY CLERK
Authorized Official Telephone Number:
712-544-2404

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  2830800 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0106419 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com