1336428291 NPI number — PLANNED PARENTHOOD OF THE HEARTLAND

Table of content: (NPI 1336428291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336428291 NPI number — PLANNED PARENTHOOD OF THE HEARTLAND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANNED PARENTHOOD OF THE HEARTLAND
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:
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:
1336428291
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
671 VANDALIA ST
Provider Second Line Business Mailing Address:
ATTN: PPH
Provider Business Mailing Address City Name:
ST PAUL
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55114-1312
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-811-7526
Provider Business Mailing Address Fax Number:
515-280-9525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
114 E MONROE #111
Provider Second Line Business Practice Location Address:
PLANNED PARENTHOOD OF THE HEARTLAND MOUNT PLEASANT CLIN
Provider Business Practice Location Address City Name:
MOUNT PLEASANT
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52641-1970
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-385-4132
Provider Business Practice Location Address Fax Number:
319-385-8220
Provider Enumeration Date:
08/10/2011

Additional Information

Authorized Official

Authorized Official Last Name:
DRAGER
Authorized Official First Name:
RANDY
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
651-698-2406

Provider Taxonomy Codes

  • Taxonomy code: 363LW0102X , with the licence number:  33019 , 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: GROUP0057570 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com